Glomerular crescents in renal amyloidosis: an epiphenomenon or distinct pathology?

Pathology International
M NagataT Watanabe

Abstract

There have been several reports of cases of renal amyloidosis with glomerular crescents. However, it is not clear whether the association is fortuitous or pathogenic related. The present study analyzed 105 cases of renal amyloidosis (61 autopsy cases and 44 biopsy cases) and found glomerular crescents in 14 (13.3%) cases. Among the 14 cases with crescents, a female predominance was noted (male: female, 3: 11) and rheumatoid arthritis was the most common primary disease of amyloidosis. Immunohistochemical analysis demonstrated amyloid protein of AA type in 12 cases. According to the histologic classification, there were 11 cases of mesangial nodular type, which was almost exclusively accompanied by AA amyloid deposition. Of note, the incidence of crescents neither correlated with the extent of amyloid deposition nor the presence of nephrotic syndrome. By contrast, localization of amyloid deposition was closely related to crescent formation. Moreover, electron microscopic observation displayed rupture of the glomerular basement membrane at the site of amyloid deposition. Our results indicated that glomerular crescents were more frequently associated with renal amyloidosis than previously appreciated. Rupture of the fragile glomer...Continue Reading

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Citations

Aug 5, 2003·Pathology International·Sait Sen, Gülçin Başdemir
Jan 1, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Amy CrosthwaitePeter Mount
Sep 1, 2014·Surgical Pathology Clinics·Nasreen Mohamed, Samih H Nasr
Nov 27, 2015·Néphrologie & thérapeutique·Asmae BzizZaitouna Alhamany
Mar 13, 2021·Indian Journal of Nephrology·Praveen K EttaSwarnalata Gowrishankar
Aug 18, 2021·Kidney Medicine·Ann A WangAnand Srivastava

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