Extracapillary glomerulonephritis: Is there any relationship with diabetes. A literature review

Glomerular crescents may be observed in conditions other than typically rapidly progressive glomerulonephritis such as antiglomerular basement membrane disease, pauci-immune glomerulonephritis and lupus nephritis. Data on extracapillary glomerulonephritis (ECGN) in diabetic patients are limited. In this study, we have discussed whether ECGN in diabetic patients is an independent or anatomo-clinically associated with diabetes.The presence of glomerular crescents in a diabetic patient can sometimes be clearly attributed to an independent classic cause. Diabetic Nephropathy seems to be a possible cause. The pathogenesis of crescent formation in diabetic nephropathy is unknown. In most cases, the renal prognosis is pejorative despite aggressive immunosuppressive therapy. The presence of crescent in a diabetic patient without any clear cause may represent a variant phenotype of diabetic nephropathy which leads to rapid decline in Glomerular Filtration Rate and ultimately to EndStage Renal Disease. There are still several limitations to the current studies, such as the small sample sizes, which tend to give inadequate representation; making them more hypothesis-generating than confirmatory. Large clinical and immunopathological studies with a broad spectrum of disease severity will be required to ascertain whether such presentations represent a distinct pathogenic phenotype of DN. Exploring the relationship between crescent formation and diabetic glomerulosclerosis is needed to completely uncover the mechanism of the non-inflammatory crescent formation.