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Pauci-Immune GN — SCE Rheumatology MCQ

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HardVasculitisPauci-Immune GNSCE Rheumatology

Kidney biopsy in a patient with suspected ANCA-associated vasculitis shows crescentic glomerulonephritis described as pauci-immune. What does this mean?

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Correct answer: E — Few immunoglobulin or complement deposits on immunofluorescence

The best answer is “Few immunoglobulin or complement deposits on immunofluorescence”. Pauci-immune describes minimal immune staining despite necrotizing crescentic injury and supports ANCA-associated vasculitis in the appropriate context. It does not mean absent histological inflammation, infection, granular immune complexes or amyloid fibrils. The term therefore describes the immunopathological pattern, not the severity of light-microscopic injury, and it must still be integrated with ANCA testing and the systemic phenotype.

Reference: BSR ANCA-associated vasculitis guideline: https://academic.oup.com/rheumatology/article/64/8/4470/8160140