title: Management of crescentic glomerulonephritis: what are the recent advances?
abstract: Crescentic glomerulonephritis (GN) is a life-threatening clinical syndrome characterized by crescents which are morphological manifestations of severe glomerular injury. Immunologically, crescentic GN are classified as anti-glomerular basement membrane nephritis, immune complex-mediated GN and pauci-immune GN. Conventional treatment for crescentic GN mainly consists of corticosteroids, immunosuppressants and plasma exchange. Plasmapheresis is beneficial for patients with Goodpasture's syndrome and those with severe pauci-immune GN. Recently, new therapeutic agents have emerged, such as monoclonal antibodies to T cells, B cells and cytokines (e.g. anti-CD20 antibodies and TNF-α inhibitors) and signal transduction inhibitors, which may provide satisfactory alternatives. However, most of these treatments have only been established in experimental crescentic GN, described in single cases or reported in open-label trials; thus, the safety and efficacy of these agents remain to be investigated via controlled clinical trials.
authors.affiliation: Department of Nephrology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000936:Antigen-Antibody Complex / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D000069283:Rituximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000936:Antigen-Antibody Complex; D001323:Autoantibodies; D014409:Tumor Necrosis Factor-alpha; C051951:antiglomerular basement membrane antibody; D000069283:Rituximab; D009173:Mycophenolic Acid