Clinico-Paraclinical Aspects and Prognostic Factors of Extracapillary Glomerulonephritis in Senegal

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Clinico-Paraclinical Aspects and Prognostic Factors of Extracapillary Glomerulonephritis in Senegal

Extracapillary glomerulonephritis or ascending glomerulonephritis are a variety of glomerulopathies that are characterized by the presence of more or less circumferential crescent-shaped cell proliferation surrounding the flocculus and associated with a sometimes major inflammatory reaction that may progress to sclerosis. Most commonly, it is a rapidly progressive glomerulonephritis (RPGN) with rapidly progressive renal failure within a few days or weeks with no tendency to spontaneous remission and presence of proteinuria and hematuria. Their diagnosis is histological by the presence of glomerular lesions involved more than 50% of glomeruli on a biopsy with at least a dozen glomeruli. The immunofluorescence (IF) test provides essential elements for the etiological diagnosis and allows to classify them in three groups according to the appearance of the deposits. Prevalence of ECGN varies between 2 and 10% of all nephrological conditions. In Europe, a German study founds an annual incidence of 0.7 / 100000. In the United States, a study conducted in March 2015 found an annual incidence of 7 cases per million inhabitant. In India, a retrospective study conducted between 2011 and 2014 showed a prevalence of 5.76%. Studies from North Africa found a ECGN incidence of 7.3% of all renal biopsies. In South Africa, a 2009 study reported a prevalence of 11.4%. In Senegal, a study in 2001 found a rate of 2% in a series of 115 renal biopsies. The objective of our study was to study epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of ECGN and to determine its factors of poor prognosis.

Conclusion
ECGN is a serious kidney disease with a very poor prognosis. This study allowed us to determine its extent in Senegal. We note that in the absence of fast and adequate management of patient evolution is inevitably towards the CKD. Early diagnosis and early management are therefore necessary to increase the chances of recovery from normal renal function and avoid progression to chronicity.

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