Rapidly progressive glomerulonephritis other diagnostic studies: Difference between revisions
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==Renal biopsy== | ==Renal biopsy== | ||
==== Light microscopy usually shows ==== | ==== Light microscopy usually shows<ref name="pmid22499296">{{cite journal |vauthors=Minz RW, Chhabra S, Joshi K, Rani L, Sharma N, Sakhuja V, Duggal R, Pasricha N |title=Renal histology in pauci-immune rapidly progressive glomerulonephritis: 8-year retrospective study |journal=Indian J Pathol Microbiol |volume=55 |issue=1 |pages=28–32 |date=2012 |pmid=22499296 |doi=10.4103/0377-4929.94850 |url=}}</ref> ==== | ||
* [[Crescentic glomerulonephritis]]: fibrinoid tuft necrosis. It can be associated with systemic vasculitis. | * [[Crescentic glomerulonephritis]]: fibrinoid tuft necrosis. It can be associated with systemic vasculitis. | ||
* In microscopic polyangitis and [[Granulomatosis with polyangiitis|Wegener’s granulomatosis]]: crescentic glomerulonephritis can present without [[fibrinoid necrosis]]. | * In microscopic polyangitis and [[Granulomatosis with polyangiitis|Wegener’s granulomatosis]]: crescentic glomerulonephritis can present without [[fibrinoid necrosis]]. | ||
* Focal and segmental mesangial proliferative glomerulonephritis. | * Focal and segmental mesangial proliferative glomerulonephritis. | ||
* Necrotizing glomerulonephritis, focal proliferative and membranous with foci of fibrinoid necrosis were the next most common category having 1 case each. | * Necrotizing glomerulonephritis, focal proliferative and membranous with foci of fibrinoid necrosis were the next most common category having 1 case each.. | ||
* Tubular changes in the form of atrophy and presence of casts and glomerular sclerosis (73.33%) were the next most common changes followed by peri-glomerular infiltrate along with myointimal hyperplasia | * Tubular changes in the form of atrophy and presence of casts and glomerular sclerosis (73.33%) were the next most common changes followed by peri-glomerular infiltrate along with myointimal hyperplasia | ||
* Glomerular basement membrane thickening and arterial hyalinization | * Glomerular basement membrane thickening and arterial hyalinization | ||
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* Focal tubular epithelial flattening as the most common findings seen in tubules of pauci-immune glomerulonephritis. | * Focal tubular epithelial flattening as the most common findings seen in tubules of pauci-immune glomerulonephritis. | ||
* In interstitium; interstitial infiltration by leukocytes is common and is most pronounced adjacent to severely inflamed glomeruli or vessels. | * In interstitium; interstitial infiltration by leukocytes is common and is most pronounced adjacent to severely inflamed glomeruli or vessels. | ||
* interstitial eosinophilic infiltrate | * interstitial eosinophilic infiltrate | ||
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- Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Renal biopsy
Light microscopy usually shows[1]
- Crescentic glomerulonephritis: fibrinoid tuft necrosis. It can be associated with systemic vasculitis.
- In microscopic polyangitis and Wegener’s granulomatosis: crescentic glomerulonephritis can present without fibrinoid necrosis.
- Focal and segmental mesangial proliferative glomerulonephritis.
- Necrotizing glomerulonephritis, focal proliferative and membranous with foci of fibrinoid necrosis were the next most common category having 1 case each..
- Tubular changes in the form of atrophy and presence of casts and glomerular sclerosis (73.33%) were the next most common changes followed by peri-glomerular infiltrate along with myointimal hyperplasia
- Glomerular basement membrane thickening and arterial hyalinization
- Tubular atrophy and focal interstitial infiltration
- Fibrinoid necrosis of the glomerular tuft was seen in 80% of the glomeruli.
- Neutrophilic infiltration of the glomerular capillary loops.
- 45% of glomeruli had (predominantly cellular) crescents and 23% were globally sclerotic.
- Increased mesangial proliferation
- Interstitial edema: interstitial oedema was seen in 80% of ANCA positive biopsies and interstitial infiltrate was seen either focally or in diffuse fashion.
- Focal tubular epithelial flattening as the most common findings seen in tubules of pauci-immune glomerulonephritis.
- In interstitium; interstitial infiltration by leukocytes is common and is most pronounced adjacent to severely inflamed glomeruli or vessels.
- interstitial eosinophilic infiltrate
Immunofluorescence microscopy
- Immunofluorescence microscopy shows finding of linear deposition of immunoglobulin G (IgG) along the glomerular capillaries and occasionally the distal tubules.
References
- ↑ Minz RW, Chhabra S, Joshi K, Rani L, Sharma N, Sakhuja V, Duggal R, Pasricha N (2012). "Renal histology in pauci-immune rapidly progressive glomerulonephritis: 8-year retrospective study". Indian J Pathol Microbiol. 55 (1): 28–32. doi:10.4103/0377-4929.94850. PMID 22499296.