TY - JOUR T1 - The Histopathological Classification of ANCA-associated Glomerulonephritis Comes of Age JF - The Journal of Rheumatology JO - J Rheumatol SP - 265 LP - 267 DO - 10.3899/jrheum.170006 VL - 44 IS - 3 AU - ANISHA TANNA AU - CHARLES D. PUSEY Y1 - 2017/03/01 UR - http://www.jrheum.org/content/44/3/265.abstract N2 - The antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV) are multisystem disorders characterized by necrotizing inflammation of blood vessels, and are associated with an untreated mortality of around 90%1. These disorders include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA), and renal limited vasculitis (RLV)2.Renal manifestations of AAV, which commonly include rapidly progressive glomerulonephritis, result in endstage renal failure or death in 40% of patients3. Despite the introduction of newer biological therapies, treatment continues to cause significant morbidity and mortality, and has been associated with more deaths at 1 year than the disease process itself4. A major challenge in the management of patients with renal AAV remains the identification of factors, both clinical and histopathological, which are predictive of response to therapy, risk of relapse, and renal and patient survival. Recognition of such factors would aid the implementation of patient-tailored therapy.Clinical factors that have been demonstrated to correlate with the prognosis of renal AAV include age, with increasing age correlating with poorer outcome; and presenting creatinine, with a better prognosis in patients presenting with a lower serum creatinine5. These clinical factors cannot, however, be considered in isolation. The “gold standard” for diagnosis of renal AAV remains the renal biopsy. A number of histopathological factors have been reported to correlate with renal prognosis6. A higher percentage of normal glomeruli has been well established as being predictive of better renal outcome6,7. A greater percentage of cellular crescents has been reported as predictive of a better response to therapy7. … Address correspondence to Prof. C.D. Pusey, Renal and Vascular Inflammation Section, Department of Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK. E-mail: c.pusey{at}imperial.ac.uk ER -