Glomerulonephritis in rheumatoid arthritis

Davis, James A.; Cohen, Arthur H.; Weisbart, Richard H.; Paulus, Harold E.

doi:10.1002/art.1780220911

Cited by 28 publications

(5 citation statements)

References 27 publications

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“…In the present series of cases with crescents, there was a preponderance of rheumatoid arthritis as the primary disease. Various glomerular lesions have been known to be associated with rheumatoid arthritis or to have untoward reactions to drugs 18–21 . They include mesangial proliferative glomerulonephritis, membranoproliferative glomerulonephritis, membranous glomerulonephritis and focal glomerulosclerosis 22 .…”

Section: Discussionmentioning

confidence: 99%

Glomerular crescents in renal amyloidosis: An epiphenomenon or distinct pathology?

Nagata¹,

Shimokama

Harada

et al. 2001

Pathology International

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There have been several reports of cases of renal amyloidosis with glomerular crescents. However, it is not clear whether the association is fortuitous or pathogenic related. The present study analyzed 105 cases of renal amyloidosis (61 autopsy cases and 44 biopsy cases) and found glomerular crescents in 14 (13.3%) cases. Among the 14 cases with crescents, a female predominance was noted (male: female, 3: 11) and rheumatoid arthritis was the most common primary disease of amyloidosis. Immunohistochemical analysis demonstrated amyloid protein of AA type in 12 cases. According to the histologic classification, there were 11 cases of mesangial nodular type, which was almost exclusively accompanied by AA amyloid deposition. Of note, the incidence of crescents neither correlated with the extent of amyloid deposition nor the presence of nephrotic syndrome. By contrast, localization of amyloid deposition was closely related to crescent formation. Moreover, electron microscopic observation displayed rupture of the glomerular basement membrane at the site of amyloid deposition. Our results indicated that glomerular crescents were more frequently associated with renal amyloidosis than previously appreciated. Rupture of the fragile glomerular basement membrane by amyloid deposition, as revealed by immunostaining and electron microscopy, may be the mechanism of crescent formation. We suggest that glomerular crescents are a distinct pathology associated with renal amyloidosis, not fortuitous conditions.

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Section: Discussionmentioning

confidence: 99%

Glomerular crescents in renal amyloidosis: An epiphenomenon or distinct pathology?

Nagata¹,

Shimokama

Harada

et al. 2001

Pathology International

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“…Among the 8 cases of 'malignant vascular syndrome' with renal in volvement described by Meriwether et al [7], only I pa tient had diffuse glomerulonephritis; IF and EM data were not reported. Recently, another case of 'proliferative glomerulonephritis' in association with RA has been re ported [13], but IF and EM findings of renal pathology strongly suggested the presence of systemic lupus erytematosus (SLE).…”

Section: Discussionmentioning

confidence: 99%

Extracapillary Glomerulonephritis with Necrotizing Vasculitis in <i>D</i>-Penicillamine-Treated Rheumatoid Arthritis

Banfi

Imbasciati

Guerra

et al. 1983

Nephron

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Rapidly progressive glomerulonephritis occurred in a woman with rheumatoid arthritis (RA) who had been treated with D-penicillamine for 3 months. Light microscopy study of the kidney showed severe glomerulonephritis with crescent formation in 50% of glomeruli and necrotizing vasculitis. Immunofluorescence revealed IgA and C3 granular deposits diffusely distributed along the capillary walls. The patient was treated with steroid ‘pulse’, antiplatelet agents and heparin and a partial recovery of renal function was observed after 2 months of anuria. This renal picture is unlike that reported in RA and a causative role for D-penicillamine is suggested.

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“…Although GN is a rare complication in RA, a well-docu mented case of proliferative GN in association with RA has been reported [1], Recently, Sellars et al [2] reported that an increase of the mesangial matrix and/or cells was a dominant abnormality in some patients with RA, al though mesangia! IgA deposition was not observed.…”

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confidence: 99%

“…In fact, GN was diagnosed in only 4 of 5,232 patients with RA at the UCLA Center for the Health Science [1], We experienced 14 patients with RA complicated with hematuria and/or proteinuria, among 132 patients with RA, and describe here 2 patients with IgA nephropathy (IgA N) among them.…”

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confidence: 99%