Anti-glomerular basement membrane glomerulonephritis - A morphologic study of 80 cases

Anti-glomerular basement membrane (anti-GBM) glomeridonephritis is a rare disease caused by IgG autoantibodies against the glomerular basement membrane. We describe clinical and pathologic findings in a series of renal biopsy specimens from 80 patients. The patients ranged in age from 16 to 87 years. The age distribution was bimodal, with one peak at a young age predominated by males and a second peak in the sixth to eighth decades with females predominating. Most patients (70 [88%]) had severe necrotizing glomeridonephritis with crescents in more that 50% of glomeruli. The fraction of crescentic glomeruli in biopsy specimens correlated well with serum creatinine levels but not with serologic titers for anti-GBM antibodies. Interstitial fibrosis was uncommon. and, when, present, minimal to mild. Linear IgG deposition defines this entity, but immunofluorescent costa in mg for other immunoglobidins and complement is found frequently. To our knowledge, this is the largest series of renal biopsy specimens with anti-GBM glomerulonephritis studied to date.