Focal proliferative and necrotizing glomerulonephritis presenting with mild urinary abnormalities and normal renal function in a young adult

Abstract

Anti-neutrophil cytoplasmic antibody–associated crescentic glomerulonephritis commonly presents as a renal emergency requiring timely care to reduce risk of kidney failure and related mortality. Milder forms of disease are less common, and it requires a high index of suspicion to detect them. Herein, we report a case of focal proliferative and necrotizing glomerulonephritis in a 21-year-old patient presenting with a new-onset microscopic haematuria and minimal proteinuria associated with normal renal function.

Unusual cases of crescentic glomerulonephritis with normal renal function at diagnosis: a retrospective case series from a single center in Western China

“…Our patients had signi cantly lower involvement of the tubular injury, lower proportions of glomerular sclerosis and brous crescents in normal eGFR group and supporting that this may have played a role in their relatively preserved renal function. Indeed 50% of renal function may be lost before serum creatinine is elevated and therefore a relatively normal serum creatinine does not exclude RPGN 27 . Findings of proteinuria and hematuria are not speci c for RPGN but are more sensitive than serum creatinine in early stages of the disease 27 .…”

“…Indeed 50% of renal function may be lost before serum creatinine is elevated and therefore a relatively normal serum creatinine does not exclude RPGN 27 . Findings of proteinuria and hematuria are not speci c for RPGN but are more sensitive than serum creatinine in early stages of the disease 27 . Last, in our study more severe hypocomplementemia, higher titers of ANA, ds-DNA and higher intensity of peripheral capillary IgG, IgA, IgM, C3 and C1q deposition by Immuno uorescence were observed in normal eGFR group, consistent with previous opinions that cellmediated immunity plays a key role in crescent formation, with the increasing rate of crescent and uremia state, humoral immunity response may be relatively suppressed, which could be proved by increasing levels of complement, immunoglobulin, cryoglobulins and CD20 + cells, thus resulting in less mature B cells and less autoantibodies production, as well as less immune complex deposit in renal tissues 1,[28][29][30][31][32][33] .…”