title: Pauci-immune necrotizing crescentic glomerulonephritis with crescentic and full moon extracapillary proliferation: clinico-pathologic correlation and follow-up study.
abstract: The prognostic value of the type and extent of extracapillary proliferation (ECP) in pauci-immune necrotizing crescentic glomerulonephitis (PIGN) was evaluated in this study. In 141 PIGN cases, all glomeruli with ECP were grouped according to type (cellular, fibrocellular and fibrous) and extent of the lesions in Bowman's space; (segmental, semicircumferential and circumferential, which might be termed full moon-FM). Cases with cellular and fibrous lesions involving ≥ 50% of glomeruli with ECP were classified as cellular and fibrous groups, respectively, while the remaining cases were classified as fibrocellular. Cases with segmental and circumferential (FM glomerulus) lesions involving ≥ 50% of glomeruli with ECP were classified as ECPI and ECPIII (FM) groups, respectively, while the rest were classified as ECPII. All the cases were classified according to Berden et al. Significant results were only nearly obtained for the FM group, including the need for dialysis. The Cox regression model revealed a 2.6-fold risk for FM cases regarding dialysis requirement. We propose that the percentage of FM glomeruli should be noted in the pathology report, and cases with more than 50% of FM glomeruli (FM group) should be identified in the group with increased risk of dialysis requirement. Our series also suggests that classification according to Berden et al. is of clinical relevance.
authors.affiliation: Department of Pathology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey. mehtat.unlu@deu.edu.tr
authors.forename: Mehtat
authors.initials: M
authors.lastname: Unlu
authors.forename: Saba
authors.initials: S
authors.lastname: Kiremitci
authors.forename: Arzu
authors.initials: A
authors.lastname: Ensari
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozluk
authors.forename: Isin
authors.initials: I
authors.lastname: Kilicaslan
authors.forename: Binnaz Handan
authors.initials: BH
authors.lastname: Ozdemir
authors.forename: Deniz
authors.initials: D
authors.lastname: Ates
authors.forename: Dilek
authors.initials: D
authors.lastname: Ertoy Baydar
authors.forename: Ipek Isik
authors.initials: II
authors.lastname: Gonul
authors.forename: Leyla
authors.initials: L
authors.lastname: Memis
authors.forename: Banu
authors.initials: B
authors.lastname: Sarsik
authors.forename: Sait
authors.initials: S
authors.lastname: Sen
authors.forename: Bahar
authors.initials: B
authors.lastname: Akkaya
authors.forename: Diclehan
authors.initials: D
authors.lastname: Orhan
authors.forename: Gulfiliz
authors.initials: G
authors.lastname: Gonlusen
authors.forename: Hulya
authors.initials: H
authors.lastname: Ellidokuz
authors.forename: Sibel
authors.initials: S
authors.lastname: Ada
authors.forename: Caner
authors.initials: C
authors.lastname: Cavdar
authors.forename: Tulin
authors.initials: T
authors.lastname: Akagun
authors.forename: Sevil
authors.initials: S
authors.lastname: Kamali
authors.forename: Kenan
authors.initials: K
authors.lastname: Aksu
authors.forename: Veli
authors.initials: V
authors.lastname: Yazisiz
authors.forename: Saime
authors.initials: S
authors.lastname: Paydas
authors.forename: Alper
authors.initials: A
authors.lastname: Soylu
authors.forename: Sulen
authors.initials: S
authors.lastname: Sarioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000473:pathology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult