Case report of rapidly progressive glomerulonephritis due to anti-glomerular basement membrane antibodies

  • María Eugenia Zoppi Servicio de Nefrología, Diálisis y Trasplante Renal, Sanatorio Mitre, Buenos Aires, Argentina
  • Lorenzo Marovelli Servicio de Nefrología, Diálisis y Trasplante Renal, Sanatorio Mitre, Buenos Aires, Argentina
  • María Marta Paz Servicio de Nefrología, Diálisis y Trasplante Renal, Sanatorio Mitre, Buenos Aires, Argentina
  • César Agost Carreño Servicio de Nefrología, Diálisis y Trasplante Renal, Sanatorio Mitre, Buenos Aires, Argentina
  • Florencia Díaz de la Fuente Centro de Patología Dr. Boris Elsner, Buenos Aires, Argentina
Keywords: anti-GBM antibodies, glomerular basement membrane, pauciimmune, immunosuppression, rituximab, rapidly progressive glomerulonephritis

Abstract

Once again in internal medicine we cannot do a diagnosis without invasive methods. Daily advances in the finding of new paraclinical tools do not allow the replacement of certain methods such as pathological anatomy. The case presented is a sample of this. This is a 27-year-old woman with a history of Hashimoto's thyroiditis who consults for presenting severe impairment of kidney function associated with oligoanuria. We performed a review of the treatment of the rapidly progressive glomerulonephritis for serologically negative anti-GBM antibodies.

References

1) Fogo AB, Kashgarian M. Diagnostic atlas of renal pathology. 3rd ed. Philadelphia, PA: Elsevier, 2017, pp. 246-77.

2) Berden AE, Ferrario F, Hagen EC, Jayne DR, Jennette JC, Joh K, et al. Histopathologic classification of ANCA-associated glomerulonephritis. J Am Soc Nephrol. 2010;21(10):1628-36. doi: 10.1681/ASN.2010050477.

3) Sinico RA, Radice A, Corace C, Sabadini E, Bollini B. Anti-glomerular basement membrane antibodies in the diagnosis of Goodpasture syndrome: a comparison of different assays. Nephrol Dial Transplant. 2006;21(2):397-401. doi: 10.1093/ndt/gfi230.

4) Chen M, Kallenberg CG, Zhao MH. ANCA-negative pauci-immune crescentic glomerulonephritis. Nat Rev Nephrol. 2009;5(6):313-8. doi: 10.1038/nrneph.2009.67.

5) Turner AN, Rees AJ. Antiglomerular basement membrane disease. En: Cameron JS, Davison AM, Grunfeld JP, et al. Oxford textbook of nephrology. 3rd ed. Oxford: Oxford University Press, 2005, pp. 579-600.

6) Fernandes R, Freitas S, Cunha P, Alves G, Cotter J. Goodpasture’s syndrome with absence of circulating anti-glomerular basement membrane antibodies: a case report. J Med Case Rep. 2016;10:205. doi: 10.1186/s13256-016-0984-6.

7) Nishibata Y, Masuda S, Nakazawa D, Tanaka S, Tomaru U, Nergui M, et al. Epitope recognized by anti-glomerular basement membrane (GBM) antibody in a patient with repeated relapse of anti-GBM disease. Exp Mol Pathol. 2019;107:165-70. doi: 10.1016/j.yexmp.2019.02.005.

8) Lemahieu W, Ombelet S, Lerut E, Jamar S, Sprangers B. Reversal of dialysis-dependent anti-glomerular basement membrane disease using plasma exchange, glucocorticosteroids, and rituximab. Kidney Int Rep. 2018;3(5):1229-32. doi: 10.1016/j.ekir.2018.04.015.

9) Touzot M, Poisson J, Faguer S, Ribes D, Cohen P, Geffray L, et al. Rituximab in anti-GBM disease: A retrospective study of 8 patients. J Autoimmun. 2015;60:74-9. doi: 10.1016/j.jaut.2015.04.003.

10) Geetha D, Specks U, Stone JH, Merkel PA, Seo P, Spiera R, et al. Rituximab for ANCA-Associated Vasculitis Immune Tolerance Network Research Group. Rituximab versus cyclophosphamide for ANCA-associated vasculitis with renal involvement. J Am Soc Nephrol. 2015;26(4):976-85. doi: 10.1681/ASN.2014010046
Published
2020-12-15
How to Cite
1.
Zoppi ME, Marovelli L, Paz MM, Agost Carreño C, Díaz de la Fuente F. Case report of rapidly progressive glomerulonephritis due to anti-glomerular basement membrane antibodies. Rev Nefrol Dial Traspl. [Internet]. 2020Dec.15 [cited 2024Dec.27];40(4):325-9. Available from: http://vps-1689312-x.dattaweb.com/index.php/rndt/article/view/575
Section
Case Report