A unique case of anti-GBM disease with concomitant anti-PLA2R positivity

BMC Nephrology

Case Report

Adél Molnár¹  Ákos Pethő¹  András Tislér¹  Deján Dobi² 

[1] Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary;Institute of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary;

关键词: Membranous nephropathy;    Anti-GBM disease;    Goodpasture’s syndrome;    Glomerulonephritis;   

DOI  :  10.1186/s12882-022-02941-1

 received in 2022-06-05, accepted in 2022-09-14,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundConcomitant occurrence of anti-GBM disease and anti-PLA2R positive membranous nephropathy have been previously described. However, to the best of our knowledge, this is the first case report that documents the co-occurrence of the diseases proven by both serologic and histologic methods.Case presentationA 51-year-old woman presented to hospital with nausea, bilateral lower extremity edema, dyspnea, dark urine, and then anuria. Symptoms developed one month after an upper respiratory tract infection. Laboratory results showed acute kidney injury, and hypoalbuminemia. Immunologic examination revealed both anti-GBM and anti-PLA2R positivity. Kidney biopsy demonstrated the histological features of Goodpasture’s disease and anti-PLA2R positive membranous nephropathy. Steroid, cyclophosphamide, and plasmapheresis were commenced. Despite the combined immunosuppressive, the patient remained on renal replacement therapy.ConclusionsMicrobial kidney injury can trigger multiple autoimmune diseases. The simultaneous occurrence of anti-glomerular basement (anti-GBM) disease and membranous nephropathy is extremely rare. Delayed recognition leads to delayed treatment, causing worse renal and patient outcomes, as well as increased financial costs.

【 授权许可】

CC BY   
© The Author(s) 2022. corrected publication 2023

【 图 表 】

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Fig. 5