The existence of a protracted course in crescentic glomerulonephritis

Abstract

We describe a spectrum of clinical and morphologic features which may occur in idiopathic crescentic glomerulonephritis. Of note are patients who pursue a more indolent course to renal failure in contrast to typical rapidly progressive glomerulonephritis (RPGN). Patients following this protracted course have an insidious presentation with hematuria and renal insufficiency, and at the time of renal biopsy (usually after many months of clinical illness) show less extensive involvement with crescents, which are often in both cellular and fibrous stages. This form of crescentic glomerulonephritis is further distinguished from RPGN by frequent hypertension and the nephrotic syndrome, the absence of oligo-anuria and progression to renal failure over many months or even years.

Clinical Features and Outcome in Patients with Glomerulonephritis and Antineutrophil Cytoplasmic Autoantibodies

“…In I such patient, biopsy findings at one time were compatible with focal necrotizing glomerulonephritis and cellular and fibrous crescent formation. The occurrence of a protracted form of crescentic glomerulonephritis has been reported earlier, although this form was frequently associated with the nephrotic syndrome [43]. Although ANCA-associated glomerulonephritis is accompanied by proteinuria in over 95% of the cases (data not shown), none of our patients had proteinuria within the nephrotic range.…”

Acute Kidney Injury and Chronic Kidney Disease

“…49 The group showed evidence of renal dysfunction, consisting of incident hypertension, proteinuria and hematuria, in addition to change in renal function, characterized the long-term course of patients who recovered from an episode of poststreptococcal glomerulonephritis. 50 They subsequently expanded these notions to patients with other glomerular diseases, and with decrements in renal function non-specifically.…”

An Unusual Case of Hematuria

“…The pathologic correlate of the clinical syndrome of RPGN is crescentic glomerulonephritis, in which crescents are formed by extracapillary proliferation of the epithelial cells, affecting Ͼ50% of the glomeruli (3,4). The severity of the disease is related to the degree of crescent formation, which is a nonspecific response to severe injury to the glomerular capillary wall (3).…”