Human leucocyte antigen-associated anti-glomerular basement membrane disease in siblings

Abstract We report a case of anti-glomerular basement membrane (GBM) disease in association with human leucocyte antigen (HLA) DRB1 15:01. A 71-year-old woman presented with oligoanuric acute kidney injury accompanied by high titre anti-GBM antibodies. Renal biopsy revealed a severe crescentic glomerulonephritis. Her brother had presented 6 years earlier with oligoanuric acute kidney injury. He was dual positive for MPO ANCA and anti-GBM antibodies. Renal biopsy was not performed. Both had an absence of pulmonary involvement. Tissue typing confirmed both were heterozygous for HLA DRB1 15:01 and DRB1 04:03.

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SARS-CoV-2 infection and recurrence of anti-glomerular basement disease: a case report

BMC Nephrology ◽

10.1186/s12882-021-02275-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Alexander Winkler ◽

Emanuel Zitt ◽

Hannelore Sprenger-Mähr ◽

Afschin Soleiman ◽

Manfred Cejna ◽

...

Keyword(s):

Basement Membrane ◽

Glomerular Basement Membrane ◽

Plasma Cells ◽

Rapidly Progressive Glomerulonephritis ◽

Kidney Injury ◽

Pulmonary Involvement ◽

Pulmonary Haemorrhage ◽

Basement Membranes ◽

High Avidity ◽

History Of

Abstract Background Anti-glomerular basement membrane disease (GBM) disease is a rare autoimmune disease causing rapidly progressive glomerulonephritis and pulmonary haemorrhage. Recently, an association between COVID-19 and anti-glomerular basement membrane (anti-GBM) disease has been proposed. We report on a patient with recurrence of anti-GBM disease after SARS-CoV-2 infection. Case presentation The 31-year-old woman had a past medical history of anti-GBM disease, first diagnosed 11 years ago, and a first relapse 5 years ago. She was admitted with severe dyspnoea, haemoptysis, pulmonary infiltrates and acute on chronic kidney injury. A SARS-CoV-2 PCR was positive with a high cycle threshold. Anti-GBM autoantibodies were undetectable. A kidney biopsy revealed necrotising crescentic glomerulonephritis with linear deposits of IgG, IgM and C3 along the glomerular basement membrane, confirming a recurrence of anti-GBM disease. She was treated with steroids, plasma exchange and two doses of rituximab. Pulmonary disease resolved, but the patient remained dialysis-dependent. We propose that pulmonary involvement of COVID-19 caused exposure of alveolar basement membranes leading to the production of high avidity autoantibodies by long-lived plasma cells, resulting in severe pulmonary renal syndrome. Conclusion Our case supports the assumption of a possible association between COVID-19 and anti-GBM disease.

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A case of acute kidney injury associated with anti-glomerular basement membrane antibody disease and thrombotic microangiopathy

Nihon Toseki Igakkai Zasshi ◽

10.4009/jsdt.45.973 ◽

2012 ◽

Vol 45 (10) ◽

pp. 973-978

Author(s):

Aiko Ookubo ◽

Yuka Shimizu ◽

Taisuke Irifuku ◽

Takayuki Naito ◽

Takahiko Ogawa ◽

...

Keyword(s):

Acute Kidney Injury ◽

Basement Membrane ◽

Glomerular Basement Membrane ◽

Thrombotic Microangiopathy ◽

Kidney Injury

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Early onset calciphylaxis following acute kidney injury secondary to anti-glomerular basement membrane antibody disease

BMJ Case Reports ◽

10.1136/bcr-2020-241265 ◽

2021 ◽

Vol 14 (4) ◽

pp. e241265

Author(s):

Sheikh Raza Shahzad ◽

Faris Alfaris ◽

Mustafa Erdem Arslan ◽

Swati Mehta

Keyword(s):

Acute Kidney Injury ◽

Basement Membrane ◽

Glomerular Basement Membrane ◽

Early Onset ◽

Kidney Injury ◽

Caucasian Woman ◽

History Of ◽

Stage Renal Disease ◽

End Stage

Calciphylaxis is commonly associated with end-stage renal disease (ESRD) and renal transplant. We present a rare case of early onset calciphylaxis in a patient presenting with acute kidney injury (AKI) secondary to anti-glomerular basement membrane (anti-GBM) antibody disease. A 65-year-old obese Caucasian woman with type 2 diabetes mellitus and hypertension presented with a 1-month history of painless gross haematuria and worsening lower extremity oedema. Laboratory results indicated AKI and nephrotic-range proteinuria. Anti-glomerular antibodies were elevated. Renal biopsy revealed focal crescentic glomerulonephritis with linear capillary immunoglobulin G staining consistent with anti-GBM antibody disease. She was treated with haemodialysis, plasmapheresis, steroids, bumetanide and cyclophosphamide. Two months later, she developed necrotic lesions on bilateral thighs. Wound biopsy was consistent with calciphylaxis. This case highlights that calciphylaxis, usually seen in patients with chronic kidney disease or ESRD, can manifest in patients with AKI as well.

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Falsely positive anti-glomerular basement membrane antibodies in a patient with hantavirus induced acute kidney injury - a case report

BMC Nephrology ◽

10.1186/s12882-018-1082-3 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

H. W. Zijlstra ◽

A. H. L. Mulder ◽

F. Geeraedts ◽

F. Visser

Keyword(s):

Acute Kidney Injury ◽

Case Report ◽

Basement Membrane ◽

Glomerular Basement Membrane ◽

Kidney Injury

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Atypical anti-glomerular basement membrane disease presenting as macroscopic haematuria, loin pain and acute kidney injury after intensive exercise

Clinical Kidney Journal ◽

10.1093/ckj/sfz044 ◽

2019 ◽

Vol 12 (6) ◽

pp. 801-802

Author(s):

Arnaud Le Flecher ◽

Nicolas Viallet ◽

Delphine Hebmann ◽

Bertrand Chauveau ◽

Henri Vacher Coponat

Keyword(s):

Acute Kidney Injury ◽

Basement Membrane ◽

Glomerular Basement Membrane ◽

Kidney Biopsy ◽

Kidney Injury ◽

Flank Pain ◽

Macroscopic Haematuria ◽

Intensive Exercise ◽

Original Presentation ◽

Loin Pain

Abstract We report a 35-year-old man who suffered from recurrent macroscopic haematuria after intensive exercise. One episode was associated with bilateral loin (flank) pain and severe acute kidney injury. His kidney biopsy revealed an atypical anti-glomerular basement membrane (GBM) disease typified by bright linear GBM staining for monotypic immunoglobulin G but without a diffuse crescentic phenotype and no circulating anti-GBM antibody. Outcome was spontaneously favourable. The patient had no recurrence or urine abnormality without running. The original presentation emphasized that exercise could reveal an underlying glomerulopathy.

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Anti-glomerular basement membrane nephritis with bronchial carcinoma: a case report

Journal of International Medical Research ◽

10.1177/0300060519892397 ◽

2019 ◽

Vol 48 (3) ◽

pp. 030006051989239 ◽

Cited By ~ 1

Author(s):

Chenni Gao ◽

Jingyuan Xie ◽

Xiaoxia Pan ◽

Xiaonong Chen

Keyword(s):

Acute Kidney Injury ◽

Basement Membrane ◽

Glomerular Basement Membrane ◽

Malignant Tumors ◽

Bronchial Carcinoma ◽

Kidney Injury ◽

Positive Serum ◽

Malignant Solid Tumor ◽

Nephrotic Range Proteinuria ◽

Rare Instance

Renal insufficiency is common among patients with various types of malignant tumors. However, the occurrence of anti-glomerular basement membrane (GBM) nephritis in a patient with a malignant tumor is relatively rare. Here, we describe a patient with bronchial carcinoma who exhibited acute kidney injury, hematuria, and non-nephrotic-range proteinuria. The patient had positive serum anti-GBM antibody findings and biopsy-proven anti-GBM nephritis. This is a rare instance of anti-GBM nephritis in a patient with a malignant solid tumor. Neoplasia was presumed to contribute to the development of anti-GBM nephritis through secretion of tumor-related antigens or unusual exposure to GBM.

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