[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Kidney](https://durgical.com/en/general-pathology/areas/kidney/) › Crescentic (rapidly progressive) glomerulonephritis # Crescentic (rapidly progressive) glomerulonephritis - Lesion When glomerular capillaries break, crescents fill Bowman space and kidney function can be lost in weeks. Updated Nov 12, 2026 ## Key points - Type I, anti-GBM: linear IgG and C3; with lung hemorrhage = Goodpasture syndrome. - Type II, immune complex: granular deposits; lupus, postinfectious GN, IgA nephropathy or IgA vasculitis. - Type III, pauci-immune: no or scanty immunoglobulin; ANCA (MPO in microscopic polyangiitis, PR3 in granulomatosis with polyangiitis). - Crescents: proliferating parietal cells and macrophages, driven by fibrin in Bowman space. - Segmental fibrinoid necrosis of the tuft is typical of ANCA disease. ## What it is Rapidly progressive glomerulonephritis is a clinical syndrome whose biopsy shows crescents in most glomeruli. It is divided by immunofluorescence into three types: antibodies against the basement membrane (linear), immune complexes (granular) and pauci-immune disease, usually ANCA vasculitis, with little or no staining. Early recognition matters because cellular crescents can recover and fibrous ones cannot. ## Structure - Kidneys enlarged and pale with cortical petechiae. - Crescents compress the tuft; the GBM shows breaks on silver stains and fibrin lies in Bowman space. - Crescents mature from cellular to fibrocellular to fibrous over weeks. - Anti-GBM disease shows crescents all at the same stage; ANCA disease often mixes stages. ## The three types of crescentic GN | Type | Immunofluorescence | Serology and setting | Lung involvement | | --- | --- | --- | --- | | [I: anti-GBM](https://durgical.com/en/conditions/rapidly-progressive-glomerulonephritis/) | Linear IgG and C3 along the GBM | Anti-GBM antibodies; HLA-DRB1 association; triggers such as smoking or solvents | Alveolar hemorrhage in Goodpasture syndrome | | [II: immune complex](https://durgical.com/en/conditions/lupus-nephritis/) | Granular, by cause | Lupus, postinfectious GN, IgA vasculitis; low complement in some | Uncommon | | [III: pauci-immune](https://durgical.com/en/conditions/granulomatosis-with-polyangiitis/) | Little or none | ANCA: MPO or PR3; small-vessel vasculitis | Capillaritis and nodules (GPA) | ## Clinical notes - Hematuria, falling urine output and rising creatinine over days to weeks; hemoptysis if the lungs are involved. - Anti-GBM, ANCA, complement and ANA tests are sent together because the treatment is urgent and similar. ## Memory aid Line, lumps or little: linear anti-GBM, lumpy complexes, little staining in ANCA. ## Test yourself Think of the answer, then tap the question to see it. ## Which immunofluorescence pattern defines anti-GBM disease? Smooth linear deposition of IgG along the glomerular basement membrane. ## Pauci-immune crescentic GN is usually associated with what? ANCA-associated small-vessel vasculitis: microscopic polyangiitis (MPO-ANCA) or granulomatosis with polyangiitis (PR3-ANCA). ## Why does the age of the crescents matter? Cellular crescents can resolve with treatment; fibrous crescents mean permanent loss of the glomerulus. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/crescentic-glomerulonephritis/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Type II hypersensitivity (antibody against cells)](https://durgical.com/en/immunology/type-ii-hypersensitivity/) - [Autoantibodies: the table to know](https://durgical.com/en/immunology/autoantibodies-the-table-to-know/) ## Connections ## Related 4 - [Immune mechanisms of glomerular injury](https://durgical.com/en/general-pathology/immune-mechanisms-of-glomerular-injury/) - [Patterns of glomerular injury](https://durgical.com/en/general-pathology/patterns-of-glomerular-injury/) - [ANCA-associated vasculitis](https://durgical.com/en/general-pathology/anca-associated-vasculitis/) - [Diffuse alveolar hemorrhage](https://durgical.com/en/general-pathology/diffuse-alveolar-hemorrhage/) ## Related conditions 7 - [Rapidly progressive glomerulonephritis (anti-GBM, ANCA)](https://durgical.com/en/conditions/rapidly-progressive-glomerulonephritis/) - [Granulomatosis with polyangiitis](https://durgical.com/en/conditions/granulomatosis-with-polyangiitis/) - [Microscopic polyangiitis](https://durgical.com/en/conditions/microscopic-polyangiitis/) - [Eosinophilic granulomatosis with polyangiitis (Churg–Strauss)](https://durgical.com/en/conditions/eosinophilic-granulomatosis-with-polyangiitis/) - [Lupus nephritis](https://durgical.com/en/conditions/lupus-nephritis/) - [IgA vasculitis (Henoch–Schönlein purpura)](https://durgical.com/en/conditions/iga-vasculitis/) - [Post-streptococcal glomerulonephritis](https://durgical.com/en/conditions/post-streptococcal-glomerulonephritis/) [← All of general pathology](https://durgical.com/en/general-pathology/) Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Anti-glomerular basement membrane disease: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000142.htm) (MedlinePlus, US National Library of Medicine, 2025); [Glomerulonephritis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000484.htm) (MedlinePlus, US National Library of Medicine, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/crescentic-glomerulonephritis/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/crescentic-glomerulonephritis/