An Insidious Case of Rapidly Progressive Glomerulonephritis Secondary to Pauci-Immune Crescentic Glomerulonephritis

Rapidly progressive glomerulonephritis (RPGN) is a severe type of nephritic syndrome that involves progressive loss of kidney function and can lead to significant morbidity and mortality. RPGN has many etiologies, of which pauci-immune crescenting glomerulonephritis (PICGN) is the most common; however, patients often present with nonspecific symptoms, which can lead to a delay in diagnosis and treatment. We describe one such case that was correctly identified only after multiple clinic and hospital encounters. Following the correct diagnosis, the patient was started on induction therapy with corticosteroids and rituximab with plans for outpatient maintenance therapy. We have included a discussion of the pathogenesis, epidemiology, diagnosis and treatment of RPGN, highlighting the importance of early recognition of the disease in achieving better patient outcomes.