2.3. Glomerulonephritis - Crescenting Glomerulonephritis

Question 1

What is Crescenting Glomerulonephritis also known as?

Answer 1

Focal Necrotizing Nephritis

Question 2

In which 3 main settings does Crescenting Glomerulonephritis occur in?

Answer 2

1. In the presence of Anti-Glomerular Basement Membrane Antibodies
2. Associated with Systemic Vasculitis
3. As a complication of other types of Glomerulonephritis

Question 3

What are the Characteristics of Anti-Glomerular Basement Membrane Antibodies diseases?

Answer 3

1, Goodpasture’s Disease can cause this

2. A massive crescent surrounds the whole capsule, which will become fibro-cellular causing fibrosis of the capillaries
3. This may present with Lung Haemorrhage (Haemoptysis)

Question 4

What is a condition associated with Systemic Vasculitis?

Answer 4

Wegner’s Vasculitis

Question 5

What other forms of Glomerulonephritis can cause Crescenting Glomerulonephritis?

Answer 5

1. Post-Infective Nephritis

2. IgA Glomerulonephritis

Question 6

What are the Clinical Features of Crescenting Glomerulonephritis?

Answer 6

1. Rapidly Progressing Glomerulonephritis:
   a) Rapid Deterioration of Blood Pressure
   b) Rapid Rise in Creatinine within the Serum
   c) Haematuria
   d) Proteinuria
2. Cough / Haemoptysis

Question 7

What is the Pathology of Crescenting Glomerulonephritis?

Answer 7

1. A capillary ruptures, due to the Aetiology, causing a crescent of blood within the Bowman’s Capsule.
2. This crescent of blood will expand, eventually causing the collapse (and fibrosis) of the capillary network

Question 8

What investigations are necessary in Crescenting Glomerulonephritis?

Answer 8

1. Blood Tests
2. Urinalysis (Urine Dipstick)
3. Renal Ultrasound
4. Renal Biopsy

Question 9

What is the blood test looking for?

Answer 9

1. Serum Anti-Neutrophil Cytoplasmic Antibodies (ANCA)
2. Serum Anti-GBM Antibodies
3. Anti-Nuclear Factor
4. DNA Binding

Question 10

What do Anti-Neutrophil Cytoplasmic Antibodies (ANCA) do?

Answer 10

These produce tissue damage via interactions with neutrophils on endothelial cells

Question 11

What is the Urinalysis (Urine Dipstick) looking for?

Answer 11

1. Haematuria

2. Proteinuria

Question 12

What is the purpose of the Renal Ultrasound?

Answer 12

To assess for any Renal Tract Lesion

Question 13

What treatment is necessary for Crescenting Glomerulonephritis?

Answer 13

1. Immunosuppression (Steroids)

2. Plasma Exchange (If required)

Question 14

What is the Significance of Crescenting Glomerulonephritis?

Answer 14

It is a medical emergency so action must be taken quickly