Fibrillary glomerulonephritis (FGN) is a rare cause of glomerulonephritis with poor prognosis. No standard treatment exists. We report a case of crescentic FGN presenting as rapidly progressing renal failure needing hemodialysis and treated based on Euro lupus nephritis trial protocol of low dose cyclophosphamide and glucocorticoid for induction followed by azathioprine maintenance. Patient responded very well to this therapy and was able to get off hemodialysis and continues with stable stage 3 CKD after 1 year follow up.
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