The sequential or simultaneous presentation of anti-glomerular basement membrane (anti-GBM) glomerulonephritis with membranous nephropathy (MN) has been infrequently reported. Although the mechanism underlying MN superimposed on anti-GBM glomerulonephritis is unknown, the two entities are believed to be interrelated. We report the case of a 75-year-old woman diagnosed with rapidly progressive glomerulonephritis. Renal biopsy revealed crescentic glomerulonephritis with linear and granular staining of immunofluorescent IgG1 and IgG4 granular staining on the capillary loops. Electron microscopy revealed extensive subepithelial deposits. These findings suggested simultaneous development of anti-GBM glomerulonephritis and MN in this case. Serum phospholipase A2 receptor (PLA2R) antibody was negative. The patient was treated with prednisolone and plasma exchange, resulting in resolution of renal insufficiency and a decrease in urinary protein. The rapid decrease in urinary protein and absence of PLA2R antibody suggest that the mechanism of MN associated with anti-GBM glomerulonephritis differs from that of primary MN.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411541 | PMC |
| http://dx.doi.org/10.1007/s13730-013-0094-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Atypical anti-GBM disease in pregnancy.
BMJ Case Rep
November 2024
Kidney Health Service Metronorth, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
A woman in her 20s presented with nephrotic syndrome and hyperemesis in early pregnancy. Pertinent initial investigations revealed a severe acute kidney injury, a serum albumin of 19 g/L, a random protein creatinine ratio of 800 g/mol and microscopic haematuria. All immunological and infection serology testing including anti-glomerular basement membrane (anti-GBM; ELISA) were negative.
View Article and Find Full Text PDFPediatric double-seropositive anti-glomerular basement membrane antibody disease: A case report and literature review.
Clin Nephrol Case Stud
November 2024
Department of Pediatrics, Cheikh Khalifa International University Hospital, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.
Introduction: Glomerular basement membrane (GBM) disease is a severe and exceedingly rare disorder characterized by the presence of circulating antibodies targeting the non-collagen NC1 domain of the α3 chain of collagen type IV in glomerular and alveolar basement membranes. It typically presents as rapidly progressive glomerulonephritis (RPGN), often accompanied by pulmonary hemorrhage. The occurrence of double-seropositivity for anti-GBM antibody and anti-neutrophil cytoplasmic antibody (ANCA), primarily with myeloperoxidase specificity (MPO-ANCA), is particularly uncommon in pediatric cases.
View Article and Find Full Text PDFManagement of immune-mediated glomerular diseases in the elderly.
Ren Fail
December 2024
S.C.D.U. Nefrologia, Dialisi e Trapianto, ARNAS Brotzu, Cagliari, Italy.
Article Synopsis
- Managing immune-mediated kidney diseases in elderly patients (≥75 years) is challenging due to age-related health issues and comorbidities.
- Current classification systems and treatment guidelines are insufficient for this age group, necessitating a more tailored approach.
- Treatment often involves immunosuppressive therapies, but careful drug choice and dosage are essential to minimize side effects, requiring a collaborative and patient-centered management strategy.
Anti-glomerular basement membrane disease complicated by malaria during pregnancy with successful maternal and fetal outcomes: a case report.
J Nephrol
December 2024
Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, 74200, Pakistan.
Article Synopsis
- Acute kidney injury during pregnancy is fairly common, but anti-GBM disease is a rare cause, as illustrated by a 30-year-old woman who experienced impaired kidney function during her pregnancy.
- A kidney biopsy revealed she had crescentic glomerulonephritis due to anti-GBM antibodies, which prompted aggressive treatment including steroids and plasma exchange, leading to improvement in her kidney function.
- Despite the successful treatment, the patient developed malaria later in pregnancy, resulting in complications that required an emergency cesarean section, but she ultimately delivered a healthy baby at 33 weeks.
Outcome of rituximab treatment in children with non-dialysis-dependent anti-GBM disease.
Pediatr Nephrol
February 2025
Department of Pediatrics, Dr. v. Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany.
Article Synopsis
- Anti-GBM disease is a rare and serious condition characterized by the body producing antibodies that attack a specific type of collagen in the kidneys, leading to quick kidney failure if not treated.
- Current treatment guidelines recommend using plasma exchanges and drugs like steroids and cyclophosphamide, but cyclophosphamide can have severe side effects, prompting the search for alternatives like rituximab and mycophenolate mofetil.
- A study analyzing five adolescent patients treated with rituximab and mycophenolate mofetil found promising results, with 80% showing preserved or improved kidney function after treatment, suggesting these alternatives may be less toxic and effective.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!