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The Treatment of Rapidly Progressive Crescentic Glomerulonephritis and of Goodpasture’s Syndrome

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Therapy of Renal Diseases and Related Disorders

Abstract

This chapter deals with the treatment of forms of glomerular disease characterised by extensive formation of epithelial (extracapillary) crescents. The clinical course of these forms of glomerulonephritis is usually progressive, often within days, weeks or months; hence the clinical term ‘rapidly progressive glomerulonephritis’.

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References

  1. Cameron JS: The natural history of glomerulonephritis. Int: Kincaid-Smith P, D’Apice AJF, Atkins RC (eds) Progress in Glomerulonephritis. John Wiley, New York, 1979, pp 1–25.

    Google Scholar 

  2. Whitworth JA, Morel-Maroger L, Mignon F, Richet G: The significance of extracapillary proliferation. Clinicopathological review of 60 patients. Nephron 16: 1–19, 1976.

    Article  PubMed  CAS  Google Scholar 

  3. Morita T, Suzuki Y, Churg J: Structure and development of the glomerular crescent. Am J Pathol 72: 349–360, 1973.

    PubMed  CAS  Google Scholar 

  4. Min KW, Gyorkey F, Gyorkey P, Yium JJ, Eknoyan G: The morphogenesis of glomerular crescents in rapidly progressive glomerulonephritis. Kidney Int 56, 1974.

    Google Scholar 

  5. Steslal J, Pirani CL, Okada M, Mandelanakis N, Pollak VE: Discontinuities (gaps) of the glomerular capillary wall and basement membrane in renal diseases. Lab Invest 28: 149–169, 1973.

    Google Scholar 

  6. Vassalli P, McCluskey RT: The pathogenic role of the eoagulation process in rabbit Masugi nephritis. Am J Pathol 45: 653–677, 1964.

    PubMed  CAS  Google Scholar 

  7. Lewis ED, Cavallo T, Harrington JT, Cotran RS: An immunopathologic study of rapidy progressive glomerulonephritis in the aduh. Hum Pathol 2: 185–208, 1971.

    Article  PubMed  CAS  Google Scholar 

  8. Hoyer JR, Michael AF, Hoyer LW: Immunofluorescent localisation of antihemophilic factor antigen and fibrinogen in human renal disease. J Clin Invest 53: 1375–1384, 1974.

    Article  PubMed  CAS  Google Scholar 

  9. Sitprija V, Boonpucknavig V: Extracapillary proliferative glomerulonephritis in Russell’s viper bite. Br Med J i: 1417, 1980.

    Article  Google Scholar 

  10. Naish P, Penn GB, Evans DJ, Peters DK: The effects of defibrination of nephrotoxic nephritis in the rabbit. Clin Sci 42: 643–646, 1972.

    PubMed  CAS  Google Scholar 

  11. Atkins RC, Holdsworth SR, Glasgow EF, Matthew TE: The macrophage in human rapidly progressive glomerulonephritis. Lancet i: 830–832, 1976.

    Google Scholar 

  12. Cattell V, Jameson SW: The origin of glomerular crescents in experimental nephrotoxic serum nephritis in man. Lab Invest 39: 584–590, 1978.

    PubMed  CAS  Google Scholar 

  13. Miller K, Dresner IG, Michael AF: Localisation of platelet antigens in human kidney disease. Kidney Int 18: 472–479, 1980.

    Article  PubMed  CAS  Google Scholar 

  14. Pollak VE, Mendoza N: Rapidly progressive glomerulonephritis. Med Clin N Am 55: 1397–1415, 1971.

    PubMed  CAS  Google Scholar 

  15. Glassock RJ: A clinical and immunopathologic dissection of rapidly progressive glomerulonephritis. Nephron 22: 253–264, 1978.

    Article  PubMed  CAS  Google Scholar 

  16. Spargo BH, Ordonez NG, Ringus JC: The differential diagnosis of crescentic glomerulonephritis. The pathology of specific lesions with prognostic implications. Hum Pathol 8: 187–204, 1977.

    Article  PubMed  CAS  Google Scholar 

  17. Moorthy AV, Zimmerman SW: Renal disease in the elderly: Clinicopathologic analysis of renal disease in 115 elderly patients. Clin Nephrol 14: 223–229, 1980.

    PubMed  CAS  Google Scholar 

  18. Border WA, Baehler RW, Bhathena D, Glassock RJ: IgA anti-basement membrane nephritis with pulmonary haemorrhage. Ann Intern Med 91: 21–25, 1979.

    PubMed  CAS  Google Scholar 

  19. Loughlin GM, Taussigi LM, Murphy SA, Strunk RC, Kohnen PW: Immune complex-mediated glomerulonephritis and pulmonary haemorrhage simulating goodpasture syndrome. J Pediat 93: 181–184, 1978.

    Article  PubMed  CAS  Google Scholar 

  20. Modzelewska I, Korobowicz E: Goodpasture-syndrom in verlauf einer anaphylaktoiden purpura Schonlein-Henoch. Acta Paed Acad Sci Hung 15: 233–239, 1974.

    CAS  Google Scholar 

  21. Sonsino E, Nabarra B, Kazatchkine M, Hinglais N, Kreis N: extracapillary proliferative glomerulonephritis so-called malignant glomerulonephritis. Adv Nephrol 2: 121–163, 1972.

    CAS  Google Scholar 

  22. Morrin PAF, Hinglais N, Nabarra B, Kreis H: Rapidly progressive glomerulonephritis. A clinical and pathologic study. Am J Med 65: 446–460, 1978.

    Article  PubMed  CAS  Google Scholar 

  23. Beime JG, Wagnild JP, Zimmerman SW, Machón PD, Burkholder PM: Idiopathic crescentic glomerulonephritis. Medicine 56: 349–381, 1977.

    Google Scholar 

  24. Stilmant MM, Bolton WK, Sturgill BC, Schmitt GW, Couser WG: Crescentic glomerulonephritis without immune deposits: Clinicopathologic features. Kidney Int 15: 184–195, 1979.

    Article  PubMed  CAS  Google Scholar 

  25. Cohen AH, Border WA, Shankel E, Glassock RJ: Crescentic glomerulonephritis: immune vs non-immune mechanisms. Am J Nephrol 1: 78–83, 1981.

    Article  PubMed  CAS  Google Scholar 

  26. Ogg CS, Heild GH, Cameron JS, Chantler C, Turner DR, Williams DG: Is rapidly progressive glomerulonephritis treatable? In: Schreiner GE, Winchester JF (eds) Controversies in Nephrology, 1981.

    Google Scholar 

  27. Risdon RA, Sloper JC, de Wardener HE: Relationship between renal function and histological changes found in renal biopsy specimens from patients with persistent glomerulonephritis. Lancet ii: 363–366, 1968.

    Google Scholar 

  28. Schainuck LI, Striker GE, Cutler RE, Benditt EP: Structural functional correlations in renal disease II. The correlations. Hum Pathol 1: 631–641, 1970.

    Article  PubMed  CAS  Google Scholar 

  29. Bohle A, Christ H, Grund KE, Mackenson S: The role of the interstitium of the renal cortex in renal disease. Contr Nephrol 16: 109–114, 1979.

    CAS  Google Scholar 

  30. Leonard CD, Nagle RB, Striker GE, Cutler RE, Scribner BH: Acute glomerulonephritis with prolonged oliguria. Ann Intern Med 73: 703–711, 1970.

    PubMed  CAS  Google Scholar 

  31. Bolton WK, Couser WG: Intravenous methylprednisolone therapy of acute crescentic rapidly progressive glomerulonephritis. Am J Med 66: 495–502, 1979.

    Article  PubMed  CAS  Google Scholar 

  32. McPhaul JJ, Mullins JD: Glomerulonephritis mediated by antibody to glomerular basement membrane. Immunological. clinical and histopathological characteristics. J Clin Invest 57: 351–361, 1976.

    Article  PubMed  Google Scholar 

  33. Briggs WA, Johnson JP, Teichman S, Yeager MC, Wilson CB: Antiglomerular basement membrane antibody mediated glomerulonephritis and Goodpastures syndrome. Medicine 58: 348–361, 1979.

    Article  PubMed  CAS  Google Scholar 

  34. Benoit FL, Rulon DB, Theil GB, Doolan PD, Watten RH: Goodpasture’s syndrome. A clinicopathologic entity. Am J Med 34: 424–444, 1964.

    Article  Google Scholar 

  35. Proskey AJ, Weatherbee L, Easterling RE, Greene JA, Weller JM: Goodpasture’s syndrome. A report of five cases and review of the literature. Am J Med 48: 162–173, 1970.

    Article  PubMed  CAS  Google Scholar 

  36. Wilson CB, Dixon FJ: Antiglomerular basement membrane antibody-induced glomerulonephritis. Kidney Int 3: 74–89, 1973.

    Article  PubMed  CAS  Google Scholar 

  37. Cohen LH, Wilson CB, Freeman RM: Goodpasture syndrome. Recovery after severe renal insufficiency. Arch Int Med 136: 835–837, 1976.

    Article  CAS  Google Scholar 

  38. Rose GA: The natural history of polyarteritis. Br Med J 2: 1148–1152, 1957.

    Article  PubMed  CAS  Google Scholar 

  39. Frohnert PP, Sheps SG: Longtem follow up study of periarteritis nodosa. Am J Med 43: 8–14, 1967.

    Article  PubMed  CAS  Google Scholar 

  40. Leib ES, Restivo C, Paulus HE: Immunosuppressive and corticosteroid therapy of polyarteritis nodosa. Am J Med 67: 941–947, 1979.

    Article  PubMed  CAS  Google Scholar 

  41. Levy M, Broyer M, Habib R: Pathology and immunopathology of Schonlein-Henoch nephritis. In: Kincaid-Smith P, D’Apice AJF, Atkins RC (eds) Progress in Glomerulonephritis. John Wiley, New York, 1979, pp 261–282.

    Google Scholar 

  42. Brown CB, Wilson D, Turner D, Cameron JS, Ogg CS, Chantler C, Gill D: Combined immunosuppression and anticoagulation in rapidly progressive glomerulonephritis. Lancet ii: 1166–1172, 1974.

    Google Scholar 

  43. Kincaid-Smith P, Saker BM, Fairley KF: Anticoagulants in irreversible acute renal failure. Lancet ii: 1360–1363, 1968.

    Google Scholar 

  44. Silfverskiold BP: Heparin und experimentelle glomerulonephritis. Skand Arkh Physiol 83: 175–182, 1940.

    CAS  Google Scholar 

  45. Kleinerman J: Effects of heparin on experimental nephritis in rabbits. Lab Invest 3: 495–508, 1954.

    PubMed  CAS  Google Scholar 

  46. Halpem B, Lagrue G, Fray A, Morard J-C, Milliez P: Sur le traitement des nephropathies experimentales par I’heparine. Perspectives d’application clinique. Presse Med 73:57– 62, 1965.

    Google Scholar 

  47. Border WA, Wilson CB, Dixon FJ: Failure of heparin to affect two types of experimental glomerulonephritis in rabbits. Kidney Int 8: 140–148, 1975.

    Article  PubMed  CAS  Google Scholar 

  48. Thomson NM, Simpson IJ, Peters DK: A quantitative evaluation of anticoagulants in experimental nephrotoxic nephritis. Clin Exp Immunol 19: 301–308, 1975.

    PubMed  CAS  Google Scholar 

  49. Cameron JS: The treatment of glomerulonephritis with inhibitors of coagulation. In: Kluthe R, Vogt A, Batsford S (eds) Glomerulonephritis. John Wiley, New York, 1977, pp 154–164.

    Google Scholar 

  50. Arieff A, Pinggera W: Rapidly progressive glomerulonephritis treated with anticoagulants. Arch Int Med 129: 77–84, 1972.

    Article  CAS  Google Scholar 

  51. Sue JM, Durand D, Conte J, Mignon-Conte M, Orfila C, Ton That H, Duchet JP: The use of heparin in the treatment of idiopathic rapidly progressive glomerulonephritis. Clin Nephrol 5: 9–13, 1976.

    Google Scholar 

  52. Cameron JS, Leathem A, Sue JM, Briggs JD, Maggiore Q: Are anticoagulants beneficial in the treatment of rapidly progressive glomerulonephritis? Proc Eur Dial Transplant Assoc 10: 57–90, 1973.

    PubMed  CAS  Google Scholar 

  53. Nakamoto Y, Dohi K, Fijioka M, Kida H, Hattori N, Takeuchi J: Combined anticoagulant and immunosuppression treatment in rapidly progressive glomerulonephritis (RPGN). Jpn J Med 18: 210–217, 1979.

    Article  Google Scholar 

  54. Bell PRF, Briggs JD, Caiman KC, Paton AM, Wood RFM, Macpherson SO, Kyle K: Reversal of acute clinical and experimental organ rejection using large doses of intravenous prednisolone. Lancet 1: 876–880, 1971.

    Article  PubMed  CAS  Google Scholar 

  55. Cathcart ES, Idelson BA, Scheinberg MA, Couser WG: Beneficial effects of methyl prednisolone ‘pulse’ therapy in diffuse proliferative lupus nephritis. Lancet i: 163–166, 1976.

    Google Scholar 

  56. Cole R, Brocklebank JT, Kienstra RA, Kissane JM, Robson AM: ‘Pulse’ methyl prednisolone therapy in the treatment of severe glomerulonephritis. J Pediat 88: 307–314, 1976.

    Article  PubMed  CAS  Google Scholar 

  57. O’Neill WM, Etheridge WB, Bloomer A: High dose corticosteroids. Their use in treating idiopathic rapidly progressive glomerulonephritis. Arch Int med 139: 514–518, 1979.

    Article  Google Scholar 

  58. Oredugba O, Mazumdar DC, Meyer JS, Lubowitz H: Pulse methyl prednisolone therapy in idiopathic, rapidly progressive glomerulonephritis. Ann Intern Med 92: 504–506, 1980.

    PubMed  CAS  Google Scholar 

  59. a. Bruns FJ, Fraley DS, Alder S, Segel DP: Megadose methyl prednisolone versus plasmapheresis in treatment of rapidly progressive glomerulonephritis (RPGN). Abstracts, 13th Annual Meeting, American Society of Nephrology, 1980, pl4A.

    Google Scholar 

  60. Bolton WK: Pulse methyl prednisolone therapy (Rx) of idiopathic acute crescentic rapidly progressive glomerulonephritis (AC-RPGN). Abstracts, American Society of Nephrology, 1980, p 13A.

    Google Scholar 

  61. Lockwood CM, Rees AJ, Pinching AJ, Pussell B, Sweny P, Uff J, Peters DK: Plasma exchange and immunosuppression in the treatment of fulminating immune-complex crescentic nephritis. Lancet 1: 63–67, 1977.

    Article  PubMed  CAS  Google Scholar 

  62. Lockwood CM, Peters DK: Plasma exchange in glomerulonephritis and related vasculitides. Ann Rev Med 31: 167–179, 1980.

    Article  PubMed  CAS  Google Scholar 

  63. Wing EJ, Bruns FJ, Fraley DS, Segel DP, Adler S: Infectious complications with plasmapheresis in rapidly progressive glomerulonephritis. JAMA 244: 2423–2426, 1980.

    Article  PubMed  CAS  Google Scholar 

  64. Becker GJ, D’Apice AJF, Walker RG, Kincaid-Smith P: Plasmapheresis in the treatment of glomerulonephritis. Med J Aust 2: 693–697, 1977.

    PubMed  CAS  Google Scholar 

  65. McKenzie PF, Taylor AE, Woodroffe AJ, Seymour AE, Chan Y-I, Clarkson AR: Plasmapheresis in glomerulonephritis. Clin Nephrol 12: 98–108, 1979.

    Google Scholar 

  66. Harmer D, Finn R, Goldsmith HJ, Bone JM, Forbes AW: Plasmapheresis in fulminating crescentic nephritis. Lancet 1:679, 1979 (letter).

    Google Scholar 

  67. de Torrente A, Popovtzer MM, Guggenheim SJ, Schrier RW: Serious pulmonary haemorrhage, glomerulonephritis and massive steroid therapy. Ann Intern Med 83: 218–219, 1975.

    PubMed  Google Scholar 

  68. Johnson JP, Whitman W, Briggs WA, Wilson CB: Plasmapheresis and immunosuppressive agents in antibasement membrane antibody-induced Goodpasture’s syndrome. Am J Med 64: 354–349, 1978.

    Article  PubMed  CAS  Google Scholar 

  69. Walker RG, D’Apide AJF, Becher GJ, Kincaid-Smith P, Craswell PWT: Plasmapheresis in Goodpasture’s syndrome and with renal failure. Med J Aust 1: 875–879, 1977.

    PubMed  CAS  Google Scholar 

  70. Erickson SB, Kurtz SB, Donadio JV, Holley KE, Wilson CB, Pineda AA: Use of combined plasmapheresis and immunosuppression in the treatment of Goodpasture’s syndrome. Mayo Clin Proc 54: 714–720, 1979.

    PubMed  CAS  Google Scholar 

  71. Münk ZM, Skamene E: Goodpasture’s syndrome - Effects of plasmapheresis. Clin Exp Immunol 36: 244–249, 1979.

    PubMed  Google Scholar 

  72. Asaba H, Rekola S, Bergstrand A, Wasserman H, Bergstrom J: Clinical trial of plasma exchange with a membrane filter in treatment of crescentic glomerulonephritis. Clin Nephrol 14: 60–65, 1980.

    PubMed  CAS  Google Scholar 

  73. Swainson CP, Robson JS, Urbaniak SJ, Keller AJ, Kay AB: Treatment of goodpasture’s disease by plasma exchange and immunosuppression. Clin Exp Immunol 32, 233–240, 1978.

    PubMed  CAS  Google Scholar 

  74. Ewan P, Jones HA, Rhodes CG, Hughes JMB: Detection of pulmonary haemorrhage with carbon monoxide uptake. Application in Goodpasture’s syndrome. N Engl J Med 295: 1391–1396, 1976.

    Article  PubMed  CAS  Google Scholar 

  75. Rees AJ, Lockwood Cm, Peters DK: Enhanced allergic tissue injury in Goodpasture’s syndrome by recurrent bacterial infection. Brit Med J ii: 723–726, 1977.

    Google Scholar 

  76. Hall CL, Colvin RB, Carey K, McCluskey RT: Passive transfer of autoimmune disease with autologous IgGl and IgG2 antibodies to the tubular basement membrane in strain XIII guinea pigs: loss of self-tolerance induced by autoantibody. J Exp Med 146: 1246–1260, 1977.

    Article  PubMed  CAS  Google Scholar 

  77. Report to the Medical Research Council by the collagen diseases and hypersensitivity panel: Treatment of polyarteritis nodosa with cortisone: Results after three years. Brit Med J 1: 1399–1400, 1966.

    Google Scholar 

  78. Sack M, Cassidy JT, Bole GG: Prognostic factors in polyarteritis. J Rheumatol 2: 411–420, 1978.

    Google Scholar 

  79. Cohen RD, Conn DL, Ilstrup DM: Clinical features, prognosis and response to treatment in polyarteritis. Mayo Clin Proc 55: 146–155, 1980.

    PubMed  CAS  Google Scholar 

  80. Fauci AS, Haynes BF, Katz P: The spectrum of vasculitis: Clinical, pathologic and immunologic and therapeutic considerations. Ann Intern Med 89: 660–676, 1978.

    PubMed  CAS  Google Scholar 

  81. Pirofsky B, Bardana EJ: Immunosuppressive therapy in rheumatic disease. Med Clin N Am 61: 419–437, 1977.

    PubMed  CAS  Google Scholar 

  82. Neild GH, Lee HA: Methylprednisolone pulse therapy in the treatment of polyarteritis nodosa. Postgrad Med J 53: 382–387, 1977.

    Article  PubMed  CAS  Google Scholar 

  83. Posborg Petersen V, Olsen S, Kissmeyer-Nielsen F, Kjeldborg O: Transmission of glomerulonephritis from host to human kidney allotransplant. N Engl J Med 275:1269– 1273, 1966.

    Google Scholar 

  84. Rosenfeld J, Levi J, Robson M, Pick A, Ben-Bassat M: Fulminatingly progressive recurrent glomerulonephritis in a renal allograft. Am J Med 49: 563–567, 1970.

    Article  PubMed  CAS  Google Scholar 

  85. Cameron JS, Turner DR: Recurrent glomerulonephritis in allografts. Clin Nephrol 7: 47–54, 1977.

    PubMed  CAS  Google Scholar 

  86. Terman DS, Durante D, Buffaloe G, Mcintosh R: Attenuation of canine nephrotoxic glomerulonephritis with an extracorporeal immunoabsorbent. Scand J Immunol 6: 195–202, 1977.

    Article  PubMed  CAS  Google Scholar 

  87. Hind CRK, Lockwood CM, Evans DJ, Rees AJ: Prognosis after immunosuppression of patients with crescentic nephritis requiring dialysis. Lancet 1: 263–265.

    Google Scholar 

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© 1984 Martinus Nijhoff Publishing, Boston/ The Hague/ Dordrecht/ Lancaster

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Cameron, J.S. (1984). The Treatment of Rapidly Progressive Crescentic Glomerulonephritis and of Goodpasture’s Syndrome. In: Suki, W.N., Massry, S.G. (eds) Therapy of Renal Diseases and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3807-9_15

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  • DOI: https://doi.org/10.1007/978-1-4613-3807-9_15

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