NECROTIZING AND CRESCENTIC GLOMERULONEPHRITIS WITHOUT IMMUNOGLOBULIN DEPOSITS - RENAL LOCATION OF SYSTEMIC VASCULITIS WITH ANTINEUTROPHIL CYTOPLASM ANTIBODIES

Necrotizing and crescentic glomerulonephritis without immunoglobulin deposits (also called pauciimmune glomerulonephritis) is the cause of approximately 50 percent of acute renal failures of glomerular origin. Our study, based on 40 case-records selected on histological criteria, and on data from the literature, shows that in most cases, if not all, this type of glomerulonephritis is part of a wider systemic vasculitis which predominantly affects the glomerular capillaries. Anti-neutrophil cytoplasm antibodies are detected in three-quarters of the cases, with a specific distribution that varies according to the clinical features. In spite of the patients' age (mean: 62 years), the severity of glomerular lesions and the extra-renal diffusion of the disease, 60 percent of these patients can be cured and recover a normal, or at least acceptable renal function, provided the corticosteroid and sometimes immunosuppressive therapy is initiated at an early stage.