[Crescentic glomerulonephritis].
Concerning crescentic glomerulonephritis (CrGN) to present clinically rapidly progressive glomerulonephritis (RPGN), we reviewed mainly the clinical features, the immunopathogenesis, the therapy and its outcome in the analysis of our cases. In our 46 patients, we found 20 patients of 'idiopathic' CrGN but felt it difficult to differ whether they were pauci-immune type or immune-complex type. Recently antineutrophil cytoplasmic autoantibody (ANCA) has been generally recognized to have a high positive predictive value in the patients having 'idiopathic' RPGN of pauci-immune type, and its serum concentration is likely to correlate with the activity of the disease. Thus we feel that the check of ANCA will be necessary to resolve our question. 'Idiopathic' RPGN of pauci-immune type may also nowadays be renal-limited systemic necrotizing glomerulonephritis caused by the same mechanism of other systemic vasculitides, but the further clinical and pathogenetical study as well as revealing the significance of ANCA will be necessary in order to elucidate whether 'idiopathic' CrGN is a single homogeneous entity caused only throughout ANCA-related unknown mechanisms. Finally we referred about the infectious complications due to immunosuppressive therapy for RPGN, because we had experienced death of 22% patients due to infection.
Ueno
M
M
Department of Medicine (II), Niigata University School of Medicine.
Arakawa
M
M
D000328:Adult; D000367:Age Factors; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D014657:Vasculitis / Q000145:classification / Q000150:complications