Rapid progressive glomerulonephritis (ANCA-associated vasculitis, Goodpasture syndrome)

1. Big picture

Rapidly progressive glomerulonephritis (RPGN) is a nephrological emergency. The key clinical pattern is:

rapidly rising creatinine over days–weeks + nephritic urine sediment + crescentic glomerulonephritis on biopsy

The examiner wants you to immediately recognize:

AKI + glomerular haematuria/RBC casts = intrinsic renal disease, especially acute glomerulonephritis/RPGN. The question file directly supports this logic: AKI with glomerular haematuria or RBC cylinders suggests a renal cause such as acute glomerulonephritis.

The two most important life-threatening causes in this topic are:

1. ANCA-associated vasculitis Pauci-immune necrotizing crescentic GN, often with systemic small-vessel vasculitis.

2. Goodpasture syndrome / anti-GBM disease Anti-glomerular basement membrane antibody disease causing pulmonary-renal syndrome.

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