Concurrent anti-glomerular basement membrane disease and membranous glomerulonephritis: A case report and literature review

M. L. Troxell, A. Bhatt Saxena, N. Kambham

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Background: Anti-glomerular basement membrane disease (anti-GBM) is a relatively rare entity characterized by antibodies to collagen type IV of glomerular and alveolar basement membranes. The sequential or simultaneous presentation of anti-glomerular basement membrane disease with membranous glomerulonephritis has been infrequently described. Case: We present the case of a 49-year-old man who had fatigue, flank pain, hematuria and renal failure. Serology was positive for anti-GBM antibodies; crescentic glomerulonephritis was seen on renal biopsy. Immunofluorescence and electron microscopy demonstrated evidence of both anti-GBM glomerulonephritis and membranous deposits. Discussion: Simultaneous anti-GBM disease and membranous glomerulonephritis is the most common temporal presentation of this rare entity. However, cases of membranous glomerulonephritis preceding or following recovery from anti-GBM disease have been described. Study of such cases provides insight into pathophysiologic mechanisms, including the possibility of increased antigen synthesis, exposure of cryptic epitopes, and/or capping and shedding of antigen-antibody complexes, in analogy to Heymann nephritis.

Original languageEnglish (US)
Pages (from-to)120-127
Number of pages8
JournalClinical Nephrology
Volume66
Issue number2
StatePublished - Aug 1 2006

Keywords

  • Anti-glomerular basement membrane
  • Good-pasture's syndrome
  • Membranous glomerulonephritis

ASJC Scopus subject areas

  • Nephrology

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