Crescentic Glomerulonephritis: Morphological Study And Its Clinicopathological Correiation

  • Sridevi Bezwada Dept of Histopathology, Apollo Hospital, Chennai, India
  • Tabassum Anjum Dept of Histopathology, Apollo Hospital, Chennai, India
  • Rama Mani Dept of Histopathology, Apollo Hospital, Chennai, India
  • Ashok Parameshwaran Dept of Histopathology, Apollo Hospital, Chennai, India
  • Mitra Gosh Dept of Histopathology, Apollo Hospital, Chennai, India


Background Extracapillary Proliferative Glomerulonephritis(Crescentic glomerulonephritis), is  usually a clinical emergency, with men being affected twice than women and consists  of   three  main categories  based   on  immunofluoresence and serology. Overall incidence regardless of country of origin is 2 – 5%.Anti – glomerular basement membrane crescentic  glomerulonephritisImmune complex mediated crescentic glomerulonephritisPauci-immune crescentic glomerulonephritisMethods:  Patients diagnosed as  Crescentic glomerulonephritis on percutaneous needle biopsies of kidney in Apollo hospital, Chennai from 1996 to 2010,  age  group from 6  to 74 yrs, with 19 males and 21 females. The mode of presentation, relevant clinical data, laboratory data, histologic features and immunofluorescence patterns are studied  and pathological  features are correlated with clinical outcome.Result: Out of 40 cases diagnosed as crescentic glomerulonephritis,  6 were followed up retrospectively  and 34  prospectively.  4  were categorized as anti-Glomerular  basement membrane , 13 as pauci-immune,, and 23  as immune-complex.Conclusion: Anti-GBM is the most aggressive form of glomerulonephritis with the highest frequency of renal insufficiency and crescent formation at the time of diagnosis as compared to pauci-immune and immune complex crescentic-GN.  Immune complex GN have a much lower frequency of crescent formation and, when crescents are present, they rarely affect 50% or more of glomeruli. Thus this study has clearly shown that even in the absence of electron microscopy a definite aetiological diagnosis can be made with histology and immunoflourescence alone  in cases of extra capillary proliferative GN presenting as a medical emergency with sudden onset of acute renal failure (RPGN) and helps the clinician in the successful management of the patient.D0i:10.21276/aabs.1657

Author Biography

Sridevi Bezwada, Dept of Histopathology, Apollo Hospital, Chennai, India


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Original Article