Rapidly progressive glomerulonephritis (RPGN)

Rapidly progressive glomerulonephritis is a term used to describe a rapid loss of renal function associated with the formation of epithelial crescents in the majority of glomeruli.

Causes

• Goodpasture's syndrome
• Wegener's granulomatosis
• others: SLE, microscopic polyarteritis

1. Type I (~20%)
   1. Goodpasture
2. Type II (~25%) - immune-complex depositions
   1. SLE-> diffuse proliferative GN --> subendothelial deposits
   2. APSGN --> subepithelial "humps"
   3. H-S purpura IgA nephropathy --> mesangial IgA deposition
3. Type III (~55%) - Pauci-immune diseases
   1. Wegeners,
   2. microscopic polyangiitis,
   3. Churg-strauss

Features

• nephritic syndrome: haematuria with red cell casts, proteinuria, hypertension, oliguria
• features specific to underlying cause (e.g. haemoptysis with Goodpasture's, vasculitic rash or sinusitis with Wegener's)

Glomeruli are full of crescents.

Rapidly progressive glomerulonephritis - aka crescentic glomerulonephritis

rapid onset, often presenting as acute kidney injury

causes include Goodpasture's, ANCA positive vasculitis and SLE