RAPIDLY PROGRESSIVE GN (RPGN)

SUMMARY

1. GN that progresses rapidly (days to weeks) & is associated glomerular crescents (extracapillary proliferation) inside Bowman's capsule.

2. Rapidly progressive renal failure with nephritic urine sediment, with high or low complement, with systemic or primary renal disorder.

3. Type 1 (deposition of anti-GBM antibodies), type 2 (immune complex deposition), type 3 (no evidence of immune deposits).

4. Causes: Goodpasture's, lupus, granulomatosis with polyangiitis, & immune complex disease.

5. Treat RPGN empirically with high-dose methylprednisolone, then prednisone + cyclophosphamide +/ plasmapheresis (if pulmonary hemorrhage).

6. Once biopsy results available, institute definitive treatment.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].