Figure 222

Approximate relative frequency of P-ANCA/MPO-ANCA versus C-ANCA/PR3-ANCA in patients with pauci-immune necrotizing and crescent glomerulonephritis without systemic vasculitis ("renal-limited vasculitis"), microscopic polyangiitis, and Wegener's granulomatosis. Note that most patients with renal-limited disease have P-ANCA/MPO-ANCA, most patients with Wegener's granulomatosis have C-ANCA/PR3-ANCA, and patients with microscopic polyangi-itis do not have a major preponderance of either ANCA specificity.

FIGURE 2-23(see Color Plate)

Early segmental fibrinoid necrosis and infiltration by neutrophils in an ANCA-positive patient with Wegener's granulomatosis (Masson trichrome stain). There also is fibrin (red/fuchsinophilic material) in Bowman's space, which is a precursor event to crescent formation.

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