Rapidly progressive glomerulonephritis due to anti-glomerular basement membrane disease accompanied by IgA nephropathy: a case report

Gao, Bixia; Li, Mingxi; Xia, Weiyi; Wen, Yubin; Qu, Zhen

doi:10.5414/cn107213

Cited by 12 publications

(7 citation statements)

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“…[8] To better understand the clinical features of concomitant anti-GBM disease with IgA nephropathy, we reviewed and summarized all concurrent anti-GBM disease and IgA nephropathy cases published in PubMed (16 cases in total, including this case), as shown in Table 1. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In these concurrent anti-GBM disease and IgA nephropathy cases, the average age is 40 years, which seems to be consistent with the classic bimodal distribution of anti-GBM disease. [24] Interestingly, the male to female ratio is 1:2, which is inconsistent with the current finding that both anti-GBM disease and IgA nephropathy are highly prevalent in men.…”

Section: Discussionmentioning

confidence: 65%

Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report

Sensen

Jingda

et al. 2022

Medicine

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Rationale: The causal relationship between anti-glomerular basement membrane (anti-GBM) disease and immunoglobulin A (IgA) nephropathy is still unclear and cases of concurrent anti-GBM disease and IgA nephropathy are very rare, especially with a good prognosis and long-term follow-up. Here, we report a case of concurrent anti-GBM disease and IgA nephropathy. By using corticosteroids and cyclophosphamide in combination with plasmapheresis, the patient achieved a very good prognosis with complete normalization of renal function and complete disappearance of hematuria and proteinuria at the subsequent follow-up. To our knowledge, no previous case with such a long follow-up and such a good prognosis have been reported. Patient concerns: This case report describes a 26-year-old Chinese woman who presented with fever as the initial symptom, followed by dysmorphic hematuria, overt proteinuria and rapidly worsening renal function. Before admission, the patient received symptomatic supportive treatment such as intravenous albumin infusion, improvement of circulation, but the symptoms were not significantly improved. Diagnosis: Per the results of kidney biopsy, the patient was diagnosed with crescentic glomerulonephritis and anti-GBM disease with IgA nephropathy. Interventions: The key to obtain a good prognosis was the early application of corticosteroids and cyclophosphamide in combination with plasmapheresis to make the anti-GBM antibody turn negative quickly. Outcomes: After 2 weeks of therapy, the patients’ anti-GBM antibody turned negative and serum creatinine improved to a normal range. After 10 months, the patient’s proteinuria level reached complete remission. After 12 months, the patient’s hematuria had disappeared completely. Lessons: This case provides experience in the treatment of concurrent anti-GBM disease and IgA nephropathy and highlights the importance of early application of plasmapheresis and immunosuppressive therapy to obtain a good prognosis.

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Section: Discussionmentioning

confidence: 65%

Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report

Sensen

Jingda

et al. 2022

Medicine

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“…It is well recognized that anti-GBM disease may co-exist with other disease entities. IgA nephropathy [4], ANCA-associated vasculitis [5], membranous nephropathy [2], and immune complex glomerulonephritis [6] have all been described, and each has the potential to confound the diagnosis. In this case, IgA nephropathy was mild with only minor and focal mesangial proliferation.…”

Section: Discussionmentioning

confidence: 99%

Hidden Tiger: An Atypical Presentation of Anti-Glomerular Basement Membrane Disease

Lecamwasam

2014

World J Nephrol Urol

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Anti-glomerular basement membrane (anti-GBM) disease is characterized by linear deposition of immunoglobulin G (IgG) along the GBM. The concurrence of anti-GBM disease with another type of glomerulonephritis has been well described. We report a case of necrotizing glomerulonephritis in association with prodromal systemic symptoms, deterioration in kidney function less rapid than expected, and the presence of circulating anti-GBM antibody. This was initially diagnosed histologically as immunoglobulin A (IgA) nephropathy based on immunohistochemistry (IHC) staining, but immunofluorescence (IF) staining on a subsequent biopsy was more consistent with a diagnosis of anti-GBM disease with coexisting mild IgA nephropathy. Prompt initiation of standard treatment of anti-GBM disease normalized kidney function. This case highlights that anti-GBM disease can present atypically and may also co-exist with another form of glomerulonephritis.

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“…There are several reports [29,30,31,32,33,34,35] about the coincidence of IgAN and other glomerular nephropathy, such as membranous nephropathy [29,30,33,34], Goodpasture syndrome [31,36], thin basement membrane nephropathy (TBMN) [37]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Concomitant Nephrotic IgA Nephropathy and Minimal Change Disease in Children

Shen

Mao

et al. 2015

Nephron

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Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis in children and adolescents worldwide. Meanwhile, minimal change disease (MCD) is the most common cause of nephrotic syndrome in children. Recently, several case reports have revealed that IgAN can be complicated by MCD in adults. Here, we report our experience concerning the features of such patients in pediatrics. Methods: The clinical manifestations and pathological features of 197 children who presented with IgAN from December 2007 to November 2013 were analyzed retrospectively based on the criteria for nephrotic syndrome and MCD. Results: Among the 197 children diagnosed with primary IgAN, 25 (12.7%) patients presented with nephrotic syndrome, and 7 patients (2.8%) presented with MCD-like pathological features and nephrotic syndrome simultaneously. The cohort of 7 patients included 5 boys, and the median age was 8.9. All of the patients who were diagnosed with primary nephrotic syndrome were treated initially with corticosteroids. Except for 1 patient with steroid resistance who was lost to follow-up, the other 6 cases presented were steroid sensitive and remained in complete remission for the last follow-up, with median and mean follow-up durations of 30.5 and 34.5 months, respectively (range 10-65 months). Conclusions: This study revealed that IgAN and MCD may also coexist in children. Moreover, most of these patients who presented with nephrotic syndrome responded well to steroids and had a favorable prognosis. Large-scale studies are required, and careful attention should be paid to such complicated cases.

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Rapidly progressive glomerulonephritis due to anti-glomerular basement membrane disease accompanied by IgA nephropathy: a case report

Cited by 12 publications

References 0 publications

Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report

Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report

Hidden Tiger: An Atypical Presentation of Anti-Glomerular Basement Membrane Disease

Clinical Characteristics of Concomitant Nephrotic IgA Nephropathy and Minimal Change Disease in Children

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