10. Rapidly progressive GN with crescents

Overview

Staining: HE

Organ: Kidney

Description:Almost all glomeruli in the slide contain some degree of fibrocellular tissue. Some glomeruli have this tissue in a half-moon-like formation called crescents. The finding of crescents is associated with RPGN.

Diagnosis: Rapidly progressing glomerulonephritis (RPGN)

(Mostly) normal glomerulus. The glomerular tuft occupies the whole Bowman’s space.

Causes:

1. Goodpasture syndrome
2. Immune complex mediated
   1. SLE
   2. Rheumatic fever
   3. IgA nephropathy
3. Pauci-immune

Theory:

Crescents are formed by proliferation of parietal cells and by migration of macrophages into the Bowman’s space. They are comprised of macrophages, fibroblasts, fibrosis and possibly necrosis.

A third glomerulus

Rapidly progressing glomerulonephritis causes rapid renal failure within days. Diagnosis is based on histology.

Another glomerulus