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The painting above shows a crescentic glomerulonephritis and necrotizing arteritis. A mixed interstitial inflammatory infiltrate is shown in the top left corner, and tubules are dilated with a few red blood cell casts. This cluster of findings can occur in ANCA-associated disease. Renal biopsy images representing manifestations of ANCA-associated glomerulonephritis are shown below. The main differential diagnosis for crescents within glomeruli includes immune complex glomerulonephritides, anti-GBM nephritis, and ANCA-associated glomerulonephritis (pauci-immune), although nearly any glomerulonephritis with mesangial and/or endocapillary proliferation can produce crescents (examples – infection-associated glomerulonephritis, fibrillary glomerulonephritis, and others). Correlation with ANCA serologies is recommended in any case...