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Sam Kant and Duvuru Geetha

Kidney involvement is a major complication of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), manifesting clinically as rapid decline in glomerular filtration rate and histologically by Pauci-immune crescentic (Figure 1) and necrotizing (Figure 2) glomerulonephritis.

Cellular crescents

Extracapillary proliferation causes glomerular tuft deflation with disappearance of normal glomerular structure and occlusion of capillary lumina. This is better shown by Jones methenamine silver (JMS) staining (A) and periodic acid−Schiff (PAS) staining (B). (Image courtesy Paride Fenaroli)

Glomerular fibrinoid necrosis at Jones methenamine silver (JMS) staining

Silver staining hallmarks glomerular basement membranes (GBMs) and allows