Back to Blog

IgA with Crescents, MEST-C

T. David Bourne, MD renal pathologist and neuropathologist at arkana laboratories
By David Bourne, MD

Nov 29, 2017

MEST-C, IgA with Crescents

This biopsy is from a young adult patient with IgA nephropathy (the immunofluorescence image in Fig. 2 shows 2+ mesangial IgA deposits). While both glomeruli show endocapillary hypercellularity, the arrow indicates one glomerulus with a cellular crescent (Fig. 1). The recently updated Oxford classification of IgA nephropathy recommends that the frequency of crescents (cellular and/or fibrocellular) be added as the “C” in the MEST-C score (see reference). Although randomized clinical trials are still needed to determine optimal therapy, a C1 score (crescents in <25% of glomeruli) identifies patients at risk for poor renal outcome if not treated with immunosuppression, and a C2 score (crescents in >25% of glomeruli) identifies patients at risk for poor renal outcome even with the addition of immunosuppressive therapy.

MEST-C, IgA with Crescents

Trimarchi H et al. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017 May; 91(5):1014-1021.



Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.