Rapidly progressive glomerulonephritis is characterized histologically by
The finding of crescents within the Bowman's space of many glomeruli is diagnostic of rapidly progressive (crescentic) glomerulonephritis (RPGN). RPGN may be subdivided into three types based on the immunofluorescence (IF) staining pattern. Type I RPGN reveals linear staining of IgG and C3. The majority of these patients are found to have Goodpasture's disease (anti-GBM disease). Type II RPGN reveals immune complex deposition (granular staining). These patients may have other glomerular or systemic diseases, including post-streptococcal GN, membranoproliferative GN, IgA nephropathy (Berger's disease), and SLE. Type III RPGN reveals minimal immune changes and is referred to as pauci-immune crescentic GN. Antineutrophil cytoplasmic antibodies (ANCAs), which are found in some patients with vasculitis, are found in many of these patients with pauci-immune GN. ANCAs are either perinuclear (P-ANCAs, against myeloperoxidase) or cytoplasmic (C-ANCAs, against proteinase 3). P-ANCAs are found in patients with microscopic polyaeritis and idiopathic crescentic GN, while C-ANCAs are found in patients with Wegener's granulomatosis, a disorder that is characterized by acute necrotizing granulomas of the respiratory tract, focal necrotizing vasculitis, and diffuse necrotizing GN Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
Fibromuscular hyperplasia of the renal aery
Crescents in the glomeruli
Neutrophils in the interstitium
Splitting of the basement membrane by mesangial cells
miscellaneous