Intravascular clotting preceding crescent formation in a patient with Wegner's granulomatosis and rapidly progressive glomerulonephritis.

Rapidly progressive glomerulonephritis is thought to be a proliferative reaction common to a number of disorders. Animal experiments implicate clotting or a product of it as its cause. In the human, the presence of fibrin in crescents, as well as the response to heparinization in some cases, support the role of coagulation in the genesis of extracapillary cell proliferation. We describe the clinical and histologic course in a patient with Wegener's granulomatosis who presented with a picture of intracapillary clotting which evolved into rapidly progressive glomerulonephritis. The patient had a remarkable return of renal function.