Crescentic glomerulonephritis without immune deposits: Clinicopathologic features. Of 46 patients with acute crescentic glomeru-Ionephritis involving 20 to 90% of glomeruli, 16 had no definable systemic disease and no significant glomerular immune deposits by immunofluorescent or electron microscopy. Anti-GBM antibody and circulating immune complexes were further excluded by radioimmunoassay and Raji cell assay in all patients tested. Clinical features included a 10: 6 male female ratio, mean age of 58 years (range, 13—77), disease duration of less than 3 months, rapidly deteriorating renal function, and frequent pulmonary manifestations. Nine patients had oliguria, serum creatinine concentrations over 6 mgIlOO ml, and required dialysis, but three of these patients subsequently recovered renal function. These three patients and seven patients with creatinine concentrations of less than 6 mgIlOO ml have not progressed to chronic renal failure. In this series, idiopathic acute crescentic glomerulonephritis without immune deposits was more common than was immune complex or anti-GBM nephritis. The clinical, laboratory, and pathologic characteristics of these patients were similar to those reported in anti-GBM and immune-complex-induced gb-merulonephritis. These observations expand the spectrum of rapidly progressive crescentic glomerubonephritis. They suggest that glomerular immune deposits may be less important than oth-er factors in determining the extent of renal injury and sub-sequent clinical course in crescentic gbomerulonephritis.

Glomérulonéphrite avec croissants sans dëpdts immuns: Carac-tères anatomocliniques. Seize parmi 46 malades atteints de gbmerulonephrite aiguè avec croissants intéressant 20 a 90% des glomérules n'avaient pas de maladie de système reconnaissable et pas de ddpôts immuns significatifs en immunofluorescence ou en microscopie electronique. La presence d'anticorps anti-GBM et de complexes immuns circulants a été, de surcroit, éliminée chez tous les malades étudiés. Les caracténstiques cliniques comprennent un rapport 10: 6 hommes: femmes, an age moyen de 58 ans (de 13 a 77), une durée de Ia maladie inférieure a 3 mois, une détérioration rapide de la fonction rénale et Ia fré-quence de manifestations pulmonaires. Neuf malades étaient oliguriques, avaient des créatinines sériques supeneures a 6 mg/