A child was diagnosed as a case of pauci-immune crescentic glomerulonephritis. The treatment to be given in this child is –
**Core Concept**
Pauci-immune crescentic glomerulonephritis is a type of rapidly progressive glomerulonephritis characterized by the presence of crescentic glomerular lesions with minimal or no immune deposits. It is often associated with anti-neutrophil cytoplasmic antibodies (ANCA) and is typically seen in patients with microscopic polyangiitis, granulomatosis with polyangiitis, or eosinophilic granulomatosis with polyangiitis.
**Why the Correct Answer is Right**
The treatment for pauci-immune crescentic glomerulonephritis involves the use of immunosuppressive agents to reduce inflammation and prevent further kidney damage. Corticosteroids, such as prednisone, are often used in combination with other immunosuppressive agents, such as cyclophosphamide or rituximab, to achieve remission. The goal of treatment is to rapidly induce remission and prevent long-term kidney damage.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not specify the use of immunosuppressive agents, which are essential in the treatment of pauci-immune crescentic glomerulonephritis.
**Option B:** This option is incorrect as it does not mention the use of corticosteroids, which are a cornerstone in the treatment of this condition.
**Option C:** This option is incorrect as it does not specify the use of cyclophosphamide or rituximab, which are often used in combination with corticosteroids to achieve remission.
**Clinical Pearl / High-Yield Fact**
It is essential to differentiate pauci-immune crescentic glomerulonephritis from other causes of rapidly progressive glomerulonephritis, such as post-infectious glomerulonephritis, as the treatment approaches differ significantly. A high index of suspicion and prompt initiation of immunosuppressive therapy are critical in preventing long-term kidney damage.
**Correct Answer:** C. Corticosteroids with cyclophosphamide or rituximab.