1981 Volume 12 Issue 2 Pages 131-137
Seven cases of rapidly progressive glomerulonephritis (RPGN) were reported. The incidence of RPGN in our university hospital between 1970 and 1980 was only 1.6%. RPGN was diagnosed histologically in cases of glomerulonephritis in which circumferential crescents were present over 50% of the observed glomeruli irrespective of the association of endocapillary changes. Three cases were idiopathic and four cases were due to lupus nephritis. Histologically seven cases were divided into two groups, one with extensive extracapillary proliferation (pure idiopathic RPGN-one case), the other with endo-and extracapillary proliferation (six cases). As reported previously, two cases with marked endocapillary proliferation were recovered from rapidly progressive renal failure by steroid pulse therapy. Immunofluorescence study showed granular deposits of IgG and C3 along the capillary walls and fibrinogen in the Bowman's capsule and capillary walls. In three cases (idiopathic 1, lupus nephritis 2), anti-GBM antibody in serum was positive and in two cases of lupus nephritis circulating immune complex (CIC) was positive with remarkable high titer. A case of LN with severe deterioration of renal function showed positive anti-GBM antibody in serum, high CIC titer and clinically and histologically remarkable changes of blood coagulation system. Then some aspects were discussed on the point of CIC, anti-GBM antibody, blood coagulation mechanism and formation of crescents in patients with RPGN.
