Pauci-immune necrotizing crescentic glomerulonephritis with crescentic and full moon extracapillary proliferation: Clinico-pathologic correlation and follow-up study

Unlu M., KİREMİTCİ S., ENSARİ A., Ozluk Y., KILIÇASLAN I., Ozdemir B. H., ...Daha Fazla

PATHOLOGY RESEARCH AND PRACTICE, cilt.209, sa.2, ss.75-82, 2013 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 209 Sayı: 2
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1016/j.prp.2012.10.012
  • Dergi Adı: PATHOLOGY RESEARCH AND PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.75-82
  • Anahtar Kelimeler: Extracapillary proliferation, Crescent, Full moon, Prognosis, Pauci-immune necrotizing crescentic glomerulonephitis, ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES, RENAL HISTOPATHOLOGY, VASCULITIS, CLASSIFICATION, DETERMINANTS, PATHOGENESIS
  • Akdeniz Üniversitesi Adresli: Evet

Özet

The prognostic value of the type and extent of extracapillary proliferation (ECP) in pauci-immune necrotizing crescentic glomerulonephitis (PIGN) was evaluated in this study.

The prognostic value of the type and extent of extracapillary proliferation (ECP) in pauci-immune necrotizing crescentic glomerulonephitis (PIGN) was evaluated in this study.

In 141 PIGN cases, all glomeruli with ECP were grouped according to type (cellular, fibrocellular and fibrous) and extent of the lesions in Bowman's space; (segmental, semicircumferential and circumferential, which might be termed full moon-FM). Cases with cellular and fibrous lesions involving >= 50% of glomeruli with ECP were classified as cellular and fibrous groups, respectively, while the remaining cases were classified as fibrocellular. Cases with segmental and circumferential (FM glomerulus) lesions involving >= 50% of glomeruli with ECP were classified as ECPI and ECPIII (FM) groups, respectively, while the rest were classified as ECPII. All the cases were classified according to Berden et al.

Significant results were only nearly obtained for the FM group, including the need for dialysis. The Cox regression model revealed a 2.6-fold risk for FM cases regarding dialysis requirement.

We propose that the percentage of FM glomeruli should be noted in the pathology report, and cases with more than 50% of FM glomeruli (FM group) should be identified in the group with increased risk of dialysis requirement. Our series also suggests that classification according to Berden et al. is of clinical relevance. (C) 2012 Elsevier GmbH. All rights reserved.