Crescentic glomerulonephritis and systemic vasculitis

  • G. Gaskin
  • C. D. Pusey
Part of the Developments in Nephrology book series (DINE, volume 40)


Crescentic glomerulonephritis was first recognized in the autopsy studies of Volhard and Fahr [1], who described cells amassed within Bowman’s capsule around severely damaged glomerular tufts, and termed the appearance ‘extra-capillary proliferation’. The more graphic term ‘crescent’ was later introduced, and is to be preferred, as it does not imply a particular origin for the cells found in Bowman’s space. The pathogenesis of crescentic glomerulonephritis is discussed more fully below. Figure 7.1 illustrates the characteristic histological appearance of crescentic glomerulonephritis. With time, it was appreciated that glomerular crescents were associated with progression to renal failure over a matter of weeks or months, and the clinical term ‘rapidly progressive glomerulonephritis’ (RPGN) was coined [2]. Initially attributed solely to post-streptococcal glomerulonephritis, the crescentic lesion was later recognized in small vessel vasculitis [3], Wegener’s granulomatosis [4] and antiglomerular basement membrane antibody-mediated disease [5], in addition to other primary glomerular and systemic inflammatory diseases [6-8]. With the accumulation of clinical data and the advent of immunohistology, three broad categories of crescentic nephritis came to be recognized:


Plasma Exchange Systemic Vasculitis Crescentic Glomerulonephritis Small Vessel Vasculitis Rapidly Progressive Glomerulonephritis 
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© Kluwer Academic Publishers 1999

Authors and Affiliations

  • G. Gaskin
  • C. D. Pusey

There are no affiliations available

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