Anti-Glomerular Basement Membrane Disease Combined with IgA Nephropathy: A Case Report and Literature Review
DOI:
https://doi.org/10.61882/89vw9y26Keywords:
Anti-glomerular basement membrane disease, IgA nephropathy, Anti- glomerular basement membrane antibodyAbstract
Anti-glomerular basement membrane (GBM) disease is a rare autoimmune disease characterized by injury to small blood vessels in the kidneys and/or lungs. IgA nephropathy is the most common primary glomerular disease diagnosed in China. However, the co-occurrence of anti-GBM illness and IgA nephropathy has been infrequently documented in the literature. At present, its mechanism is unknown, the treatment approach is unclear, and the prognosis remains poor. Herein, we report a case of anti-GBM disease complicated with IgA nephropathy, in which renal function returned to normal state following treatment with a combination of prednisone and cyclophosphamide. This case suggests that in patients with anti-GBM disease and IgA nephropathy, the combination of glucocorticoids and cyclophosphamide may serve as an optimum treatment choice.
Downloads
References
Canney M, O'Hara PV, McEvoy CM, et al. Spatial and Temporal Clustering of Anti-Glomerular Basement Membrane Disease. Clin J Am Soc Nephrol. 2016;11:1392-1399.
McAdoo SP, Pusey CD. Anti-Glomerular Basement Membrane Disease. Clin J Am Soc Nephrol. 2017;12:1162-1172.
Asim M, Akhtar M. Epidemiology, Impact, and Management Strategies of Anti-Glomerular Basement Membrane Disease. Int J Nephrol Renovasc Dis. 2022;15:129-138.
Bacalja J, Zibar L, Ljubanović DG. IgA-mediated anti-glomerular basement membrane disease. A case report. Nefrologia (Engl Ed). 2018;38:339-341.
Fervenza FC, Terreros D, Boutaud A, et al. Recurrent Goodpasture's disease due to a monoclonal IgA-kappa circulating antibody. Am J Kidney Dis. 1999;34:549-55.
Nasr SH, Collins AB, Alexander MP, et al. The clinicopathologic characteristics and outcome of atypical anti-glomerular basement membrane nephritis. Kidney Int. 2016;89:897-908.
Levy JB, Hammad T, Coulthart A, Dougan T, Pusey CD. Clinical features and outcome of patients with both ANCA and anti-GBM antibodies. Kidney Int. 2004;66:1535-40.
Li X, Huang M, Liu J. ANCA-Associated Vasculitis With Anti-GBM Disease and Two Types of Tumors: A Case Report. Front Med (Lausanne). 2021;8:810680.
Zhang S, Li C, Huang J, et al. Clinical and pathological features of anti-glomerular basement membrane disease associated with membranous nephropathy: an observational study. Ren Fail. 2022;44:1904-1914.
Salama AD, Dougan T, Levy JB, et al. Goodpasture's disease in the absence of circulating anti-glomerular basement membrane antibodies as detected by standard techniques. Am J Kidney Dis. 2002;39:1162-7.
Hellmark T, Segelmark M. Diagnosis and classification of Goodpasture's disease (anti-GBM). J Autoimmun. 2014;48-49:108-12.
Jennette JC, Nickeleit V. Anti-glomerular basement membrane glomerulonephritis and Goodpasture syndrome. In: Jennette JC, Silva FG, Olson JL, et al. (eds). Heptinstall's Pathology of the Kidney. 7th edn Philadelphia, PA: Wolters Kluwer. 2015;657–684.
Wen YK, Wen KI. An unusual case of IgA-mediated anti-glomerular basement membrane disease. Int Urol Nephrol. 2013;45:1229-34.
Saxena R, Bygren P, Butkowski R, Wieslander J. Specificity of kidney-bound antibodies in Goodpasture's syndrome. Clin Exp Immunol. 1989;78:31-6.
Dougan T, Levy JB, Salama A, George AJ, Pusey CD. Characterization of autoantibodies from patients with Goodpasture's disease using a resonant mirror biosensor. Clin Exp Immunol. 2002;128:555-61.
Levy JB, Turner AN, George AJ, Pusey CD. Epitope analysis of the Goodpasture antigen using a resonant mirror biosensor. Clin Exp Immunol. 1996;106:79-85.
Jia XY, Qu Z, Cui Z, Yang R, Zhao J, Zhao MH. Circulating anti-glomerular basement membrane autoantibodies against α3(IV)NC1 undetectable by commercially available enzyme-linked immunosorbent assays. Nephrology (Carlton). 2012;17:160-6.
Zijlstra HW, Mulder AHL, Geeraedts F, Visser F. Falsely positive anti-glomerular basement membrane antibodies in a patient with hantavirus induced acute kidney injury - a case report. BMC Nephrol. 2018;19:286.
Szczech LA, Anderson A, Ramers C, et al. The uncertain significance of anti-glomerular basement membrane antibody among HIV-infected persons with kidney disease. Am J Kidney Dis. 2006;48:e55-9.
Heitz M, Carron PL, Clavarino G, et al. Use of rituximab as an induction therapy in anti-glomerular basement-membrane disease. BMC Nephrol. 2018;19:241.
Shaojie F, Sensen S, Jingda H, et al. Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report. Medicine (Baltimore). 2022;101:e30686.
Guo C, Ye M, Li S, Zhu TT, Rao XR. Anti-glomerular basement membrane disease with IgA nephropathy: A case report. World J Clin Cases. 2022;10:3916-3922.
Ge YT, Liao JL, Liang W, Xiong ZY. Anti-Glomerular Basement Membrane Disease Combined with IgA Nephropathy Complicated with Reversible Posterior Leukoencephalopathy Syndrome: An Unusual Case. Am J Case Rep. 2015;16:849-53.
Qu W, Liu N, Xu T, et al. Case Report: Coexistence of Anti-Glomerular Basement Membrane Disease, Membranous Nephropathy, and IgA Nephropathy in a Female PatientWith Preserved Renal Function. Front Pharmacol. 2022;13:876512.
Xu D, Wu J, Wu J, et al. Novel therapy for anti-glomerular basement membrane disease with IgA nephropathy: A case report. Exp Ther Med. 2016;11:1889-1892.
Suh KS, Choi SY, Bae GE, Choi DE, Yeo MK. Concurrent Anti-glomerular Basement Membrane Nephritis and IgA Nephropathy. J Pathol Transl Med. 2019;53:399-402.
Yamaguchi H, Takizawa H, Ogawa Y, Takada T, Yamaji I, Ura N. A case report of the anti-glomerular basement membrane glomerulonephritis with mesangial IgA deposition. CEN Case Rep. 2013;2:6-10.
Shenoy SV, Rao IR, Prabhu RA, et al. Crescentic glomerulonephritis due to coexistent IgA nephropathy and anti-glomerular basement membrane disease in a patient with COVID-19 disease: A case report. Nephrology (Carlton). 2022;27:727-728.
Gupta Y, Swain M, Gowrishankar S. Antiglomerular Basement Membrane Disease Combined with IgA Nephropathy. Indian J Nephrol. 2019;29:375-377.
Bajaj V, Thakur S, Barwad A, Sinha A, Bagga A, Singh G. IgA Nephropathy and Atypical Anti-GBM Disease: A Rare Dual Pathology in a Pediatric Rapidly Progressive Glomerulonephritis. Glomerular Dis. 2022;2:54-57.
Zahir Z, Wani AS, Prasad N, Jain M. Clinicopathological characteristics and predictors of poor outcome in anti-glomerular basement membrane disease - a fifteen year single center experience. Ren Fail. 2021;43:79-89.
Hellmark T, Segelmark M, Unger C, Burkhardt H, Saus J, Wieslander J. Identification of a clinically relevant immunodominant region of collagen IV in Goodpasture disease. Kidney Int. 1999;55:936-44.
Levy JB, Turner AN, Rees AJ, Pusey CD. Long-term outcome of anti-glomerular basement membrane antibody disease treated with plasma exchange and immunosuppression. Ann Intern Med. 2001;134:1033-42.
Fisher M, Pusey CD, Vaughan RW, Rees AJ. Susceptibility to anti-glomerular basement membrane disease is strongly associated with HLA-DRB1 genes. Kidney Int. 1997;51:222-9.
Downloads
Published
Data Availability Statement
Data will be made available on reasonable request.
