Pathological Finding:
Kidney biopsy (Figure.3, A-C) showed 24 glomeruli, 23 glomeruli show
extra capillary cellular crescents, but none show fibro cellular/fibrous
crescents. The crescents are temporally homogenous at the same age and
stage and fill the space delineated by Bowman’s capsule (Figure.3, A-B),
some show rupture of Bowman’s capsule. Some glomeruli show active
periglomerular inflammation (Figure.3, A). Mild tubular atrophy and
interstitial fibrosis were also noted (10-15% of the cortical tissue),
associated with moderate multifocal interstitial inflammatory infiltrate
composed of lymphocytes and occasional eosinophils. Direct
immunofluorescent microscopy showed linear staining of IgG (Figure.3,
C), complement component C3, and light chains (kappa and lambda) along
the glomerular basement membrane. These findings of Crescentic
glomerulonephritis are consistent with Anti-Glomerular Basement Membrane
(GBM) glomerulonephritis.