The prognosis of rapidly proliferatingglomerulo-nephritis (Crescentric GN) depends upon
|A||Number of crescents|
|B||Size of crescents|
|C||Shape of crescents|
|D||Cellularity of crescents|
a. Patients present with abrupt -onset renal failure, with rapid loss of renal function (in less than 3 months); frequently normal blood pressure; and normal kidney size.
b. Nonspecific symptoms (e.g., weakness, nausea, cough, weight loss, fever, myalgia, arthralgia).
c. Extrarenal involvement, with the exception of lung involvement, is rare.
d. Renal manifestations. oliguria and azotemia
e. Pulmonary manifestations. Transient, mild pulmonary infiltrates or hemoptysis
a. There are no diagnostic laboratory findings.
b. When intrarenalvasculitis (i.e., pauci-immune glomerulonephritis) is the underlying cause, the antineutrophilic cytoplasmic antibody (ANCA) test is positive.
c. The diagnosis is based on the discovery of epithelial crescents in a majority of glomeruli in the renal biopsy specimen.
a. In anti-GBM disease, plasmapheresis and immunosuppressive.
b. In immune complex glomerulonephritis, treatment depends on the individual causative disorder.
c. In pauci-immune deposit disease, treatment involves pulse methylprednisolone and cyclophosphamide.