The immunopathological spectrum of crescentic glomerulonephritis: a survey of 106 patients in a single Chinese center.
BACKGROUND
Crescentic glomerulonephritis (CrGN) is a severe form of glomerular injury. We retrospectively analyzed data from Chinese patients with CrGN in our center to characterize the immunopathological spectrum of CrGN.


METHODS
A total of 106 consecutive patients with biopsy-proven CrGN were recruited. CrGN was classified into 3 types according to findings on immunofluorescence microscopy; type I was defined as a linear deposition of immunoglobulins along the glomerular basement membrane (GBM), type II as a glomerular deposition of immune-complex and type III as a pauci-immune deposition.


RESULTS
A total of 17/106 (16.0%) patients were classified as type I, 43/106 (40.6%) as type II and 46/106 (43.4%) as type III. Serum antineutrophil cytoplasmic antibodies (ANCA) could be detected in 1/17 (5.9%) patient with type I, 11/43 (25.6%) patients with type II and 29/46 (63.0%) patients with type III CrGN (p < 0.001). Serum anti-GBM antibodies could be detected in 14/17 (82.4%) patients with type I, 2/43 (4.7%) patients with type II and 3/46 (6.5%) patients with type III. In type II CrGN, ANCA-positive patients were older (p < 0.001), had more multi-system involvement (p < 0.001) and more fibrinoid necrosis in renal histopathology than ANCA-negative patients (p = 0.003).


CONCLUSIONS
Pauci-immune CrGN might be the most common type of CrGN in Northern China. There was much heterogeneity within each type of CrGN.
Lin
Wei
W
Renal Division, Department of Medicine, Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Peking University First Hospital, Peking University, Beijing, China.
Chen
Min
M
Cui
Zhao
Z
Zhao
Ming-Hui
MH
D000293:Adolescent; D000328:Adult; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001485:Basement Membrane / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002681:China; D003625:Data Collection / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000097:blood / Q000276:immunology* / Q000473:pathology*; D006785:Hospitals, University / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D015415:Biomarkers; C051951:antiglomerular basement membrane antibody