Rapidly progressive glomerulonephritis other diagnostic studies
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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.