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Table 145-2

Causes of Rapidly Progressive Glomerulonephritis

  • Infectious diseases
    • Poststreptococcal glomerulonephritisa
    • Infective endocarditis
    • Occult visceral sepsis
    • Hepatitis B infection (with vasculitis and/or cryoglobulinemia)
    • HIV infection
    • Hepatitis C infection (with cryoglobulinemia, membranoproliferative glomerulonephritis)
  • Multisystem diseases
    • Systemic lupus erythematosus
    • Henoch-Schönlein purpura
    • Systemic necrotizing vasculitis (including granulomatosis with polyangiitis [Wegener's])
    • Goodpasture's syndrome
    • Essential mixed (IgG/IgM) cryoglobulinemia
    • Malignancy
    • Relapsing polychondritis
    • Rheumatoid arthritis (with vasculitis)
  • Drugs
  • Idiopathic or primary glomerular disease
    • A. Idiopathic crescentic glomerulonephritis
      1. Type I-with linear deposits of Ig (anti-GBM antibody-mediated)
      2. Type II-with granular deposits of Ig (immune complex-mediated)
      3. Type III-with few or no immune deposits of Ig (“pauci-immune”)
      4. Antineutrophil cytoplasmic antibody-induced, forme fruste of vasculitis
      5. Immunotactoid glomerulonephritis
      6. Fibrillary glomerulonephritis
    • Superimposed on another primary glomerular disease
      1. Mesangiocapillary (membranoproliferative) glomerulonephritis (especially type II)
      2. Membranous glomerulonephritis
      3. Berger's disease (IgA nephropathy)

a Most common cause.

Abbreviation: GBM, glomerular basement membrane.

Source: Glassock RJ, Brenner BM: Harrison's Principles of Internal Medicine, 13th ed, 1995.