Figure 224

Glomerulus from a patient with ANCA and a pauci-immune necrotizing and crescentic glomerulonephritis showing a large circumferential crescent and segmental lysis of glomerular basement membranes (combined Jones silver and hematoxylin and eosin stain). Also note the adjacent tubulointerstitial inflammation, which often is pronounced in ANCA disease. This pattern of glomerular injury can be seen with any of the ANCA-small vessel vasculitides.

FIGURE 2-25(see Color Plate)

Direct immunofluorescence microscopy demonstrating intense staining of a crescent and adjacent segmental glomerular fibrinoid necrosis with an antiserum specific for fibrin in a renal biopsy from a patient with ANCA small vessel vasculitis. There was no staining of glomeruli in this specimen with antisera specific for IgG, IgA, or IgM.

frfr J-1 fl

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