Crescents in renal biopsies and crescentic glomerulonephritis - A 5 year study from South India
Abstract
Background: Crescents indicate active disease with rapidly deteriorating renal function. Many primary renal diseases can be associated with crescents, however only a few conditions presents as crescentic glomerulonephritis(CrGN) . The incidence varies in different population.
Aims and objective: The aim of the study was to know the incidence of CrGN and that of crescents in various glomerulopathies along with their clinicopathological associations.
Material and methods: Renal core biopsies over 5 year period were collected retrospectively from pathology archives and reviewed for crescents and CrGN. Clinical , serological, Immunoflourescence and follow up details were collected.
Results: A total of 1629 renal biopsies were received. Crescents were identified in 9.69% and 2.08% were CrGN. Males and females were equally distributed. Paediatric population constituted 24%. The most common presentation was nephritic syndrome. Cellular crescents were seen in 81 cases, fibro cellular/ fibrous in 55 cases and both in 22 cases. In immune complex(IC) mediated group, lupus nephritis (LN) showed crescents in 31.7%, followed by PIGN (29.67%) and IgAN (25.2%). Vasculitis group had 79% crescents. All cases of anti GBM disease and pauci immune ANCA negative renal limited vasculitis(PI-RLV) had crescents. The most common CrGNs were anti GBM disease (100%), followed by vasculitis (37%) and PI-RLV (33%) and least in IC group (5% in PIGN and IgAN and 3.5% in LN). Complete remission was seen in 32.2%.
Conclusion: Crescents in renal biopsies are not rare. Although CrGN is more common in vasculitis and anti-GBM disease, the incidence of IC-GN is more in our population and a significant number may show crescents.
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References
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