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pubmed-article:7970088pubmed:abstractTextCrescentic glomerulonephritis is usually classified into antiglomerular basement membrane (GBM) disease, immune-complex disease, or pauci-immune crescentic nephritis. The last category includes patients with systemic vasculitis as well as 'idiopathic' isolated crescentic nephritis. The presence of anti-neutrophil cytoplasmic antibodies (ANCA) in many patients with apparently isolated crescentic nephritis suggests that this represents a renal-limited form of vasculitis, and that truly 'idiopathic' crescentic nephritis is a very rare entity. We reviewed all renal biopsies with extracapillary proliferation seen at our centre since the availability of an ANCA assay (4-year period). There were 89 such biopsies of a total of 1240, of which 82 had sufficient details for further analysis. Of these, 10 had anti-GBM disease, 35 had epithelial proliferation associated with a variety of other diseases, and 36 had ANCA-associated disease. Nine of this last group had no extrarenal features and would previously have been classified as 'idiopathic' crescentic glomerulonephritis. The single remaining patient had an inactive glomerulonephritis with a scarred crescent; the predominant lesion was an interstitial nephritis. We therefore conclude that truly 'idiopathic' crescentic nephritis is very rare, if it exists at all. The ability to provide a practically complete classification of crescentic nephritis has important prognostic and therapeutic consequences.lld:pubmed
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pubmed-article:7970088pubmed:articleTitleDoes truly 'idiopathic' crescentic glomerulonephritis exist?lld:pubmed
pubmed-article:7970088pubmed:affiliationDepartment of Medicine, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, UK.lld:pubmed
pubmed-article:7970088pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:7970088pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed
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