10. Rapidly progressive GN with crescents

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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)

Causes:

  1. Goodpasture syndrome
  2. Immune complex mediated
    1. SLE
    2. Rheumatic fever
    3. IgA nephropathy
  3. Pauci-immune
(Mostly) normal glomerulus. The glomerular tuft occupies mostly the whole Bowman’s space.

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.

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

Another glomerulus
A third glomerulus