Three patients present with rapidly progressive glomerulonephritis and crescents involving more than 50 percent of glomeruli. Patient 1 has linear IgG along the GBM. Patient 2 has granular immune complex deposits. Patient 3 has few or no deposits by immunofluorescence. Match each patient to its category correctly.

• A Patient 1: ANCA associated pauci-immune; Patient 2: immune complex mediated; Patient 3: anti-GBM
• B Patient 1: immune complex mediated; Patient 2: anti-GBM; Patient 3: ANCA associated pauci-immune
• C Patient 1: anti-GBM; Patient 2: ANCA associated pauci-immune; Patient 3: immune complex mediated
• D Patient 1: anti-GBM; Patient 2: immune complex mediated; Patient 3: ANCA associated pauci-immune ✓

Explanation

Crescentic glomerulonephritis is classified into three types by immunofluorescence. Type I is anti-GBM disease with smooth linear IgG along the GBM against the NC1 domain of alpha-3 type IV collagen. Type II is immune complex mediated with granular deposits, seen in postinfectious GN, lupus and IgA nephropathy. Type III is pauci-immune, strongly linked to ANCAs targeting MPO or PR3, with little or no deposit staining. This IF-based triad is a standard examination point.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.