Concurrent Anti-glomerular Basement Membrane Nephritis and IgA Nephropathy

Anti–glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along the GBM. In a limited number of cases, glomerular immune complexes have been identified in anti-GBM nephritis. A 38-year-old female presented azotemia, hematuria, and proteinuria without any pulmonary symptoms. A renal biopsy showed crescentic GN with linear IgG deposition along the GBM and mesangial IgA deposition. The patient was diagnosed as concurrent anti-GBM nephritis and IgA nephropathy. Therapies with pulse methylprednisolone and cyclophosphamide administration were effective. Concurrent cases of both anti-GBM nephritis and IgA nephropathy are rare among cases of anti-GBM diseases with deposition of immune complexes. This rare case of concurrent anti-GBM nephritis and IgA nephropathy with literature review is noteworthy.

[1]  C. Mei,et al.  Novel therapy for anti-glomerular basement membrane disease with IgA nephropathy: A case report. , 2016, Experimental and Therapeutic Medicine.

[2]  M. Troxell,et al.  Atypical anti-glomerular basement membrane disease , 2015, Clinical kidney journal.

[3]  W. Liang,et al.  Anti-Glomerular Basement Membrane Disease Combined with IgA Nephropathy Complicated with Reversible Posterior Leukoencephalopathy Syndrome: An Unusual Case , 2015, The American journal of case reports.

[4]  K. Farrington,et al.  Predictors of renal and patient outcomes in anti-GBM disease: clinicopathologic analysis of a two-centre cohort. , 2015, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[5]  M. Schwartz,et al.  Heptinstall's Pathology of the Kidney , 2014 .

[6]  Y. Wen,et al.  Rapidly progressive glomerulonephritis due to anti-glomerular basement membrane disease accompanied by IgA nephropathy: a case report. , 2014, Clinical nephrology.

[7]  H. Takizawa,et al.  A case report of the anti-glomerular basement membrane glomerulonephritis with mesangial IgA deposition , 2013, CEN Case Reports.

[8]  Zhanmei Zhou,et al.  Mesangial IgA deposits indicate pathogenesis of anti-glomerular basement membrane disease. , 2012, Molecular medicine reports.

[9]  C. Nast,et al.  Anti-glomerular basement membrane disease in an HIV-infected patient , 2008, Nature Clinical Practice Nephrology.

[10]  Su-xia Wang,et al.  Concurrent Antiglomerular Basement Membrane Disease and Immune Complex Glomerulonephritis , 2006, Renal failure.

[11]  P. van Paassen,et al.  Coexistence of anti-glomerular basement membrane antibodies and myeloperoxidase-ANCAs in crescentic glomerulonephritis. , 2005, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[12]  K. Nitta,et al.  Glomerular Expression of α2(IV) and α5(IV) Chains of Type IV Collagen in Patients with IgA Nephropathy , 2002, Nephron.

[13]  G. Crary.  Heptinstall’s Pathology of the Kidney , 1999 .

[14]  K. Trpkov,et al.  Recurrence of anti-GBM antibody disease twelve years after transplantation associated with de novo IgA nephropathy. , 1998, Clinical nephrology.

[15]  M. Lamm,et al.  IgA nephropathy: pathogenesis of the most common form of glomerulonephritis. , 1989, Laboratory investigation; a journal of technical methods and pathology.