Rapidly Progressive Glomerulonephritis (RPGN) RPGN has three primary pathophysiologic causes differentiated by immunofluorescence Immune Complex Mediated (granular staining): • Low Complement: Post-strep GN, Lupus Nephritis, Cryoglobulinemia, Endocarditis, Idiopathic • Normal Complement: IgA nephropathy, Henoch-SchonIein Purpura Anti-GBM antibodies (linear staining): • Limited to Kidney: Anti-GBM Glomerulonephritis • With associated pulmonary involvement: Anti-GBM Disease (Goodpasture's) Pauci-immune mediated (Negative IF): • PR3-ANCA (C-ANCA): GPA >>> MPA > eGPA • MPO-ANCA (P-ANCA): eGPA, MPA >>> GPA Stanford Internal Medicine Chiefs @StanfordChiefs #RPGN #Rapidly #Progressive #Glomerulonephritis #Vasculitis #differential #diagnosis #algorithm #rheumatology
