PMID- 29043130
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2196-5293 (Print)
IS  - 2196-5293 (Electronic)
IS  - 2196-5293 (Linking)
VI  - 3
DP  - 2015
TI  - Anti-GBM disease after nephrectomy for xanthogranulomatous pyelonephritis in a 
      patient expressing HLA DR15 major histocompatibility antigens: a case report.
PG  - 25-30
LID - 10.5414/CNCS108594 [doi]
AB  - Antiglomerular basement membrane (anti-GBM) antibody disease is uncommon in the 
      pediatric population. There are no cases in the literature describing the 
      development of anti-GBM disease following XGP or nephrectomy. We report the case 
      of a 7-year-old boy with no past history of urological illness, treated with 
      antimicrobials and nephrectomy for diffuse, unilateral xanthogranulomatous 
      pyelonephritis (XGP). Renal function and ultrasound scan of the contralateral 
      kidney postoperatively were normal. Three months later, the child represented in 
      acute renal failure with rapidly progressive glomerulonephritis requiring 
      hemodialysis. Renal biopsy showed severe crescentic glomerulonephritis with 95% 
      of glomeruli demonstrating circumferential cellular crescents. Strong linear IgG 
      staining of the glomerular basement membranes was present, in keeping with 
      anti-GBM disease. Circulating anti-GBM antibodies were positive. Treatment with 
      plasma exchange, methylprednisolone, and cyclophosphamide led to normalization of 
      anti-GBM antibody titers. Frequency of hemodialysis was reduced as renal function 
      improved, and he is currently independent of dialysis with estimated glomerular 
      filtration rate 20.7 mls/min/1.73 m(2). Case studies in the adult literature have 
      reported the development of a rapidly progressive anti-GBM antibody-induced 
      glomerulonephritis following renal surgery where patients expressed HLA DR2/HLA 
      DR15 major histocompatibility (MHC) antigens. Of note, our patient also expresses 
      the HLA DR15 MHC antigen.
FAU - O'Hagan, Emma
AU  - O'Hagan E
AD  - 1. Royal Belfast Hospital for Sick Children, Pediatric Renal Unit, Belfast, 
      Northern Ireland.
FAU - Mallett, Tamara
AU  - Mallett T
AD  - 1. Royal Belfast Hospital for Sick Children, Pediatric Renal Unit, Belfast, 
      Northern Ireland.
FAU - Convery, Mairead
AU  - Convery M
AD  - 1. Royal Belfast Hospital for Sick Children, Pediatric Renal Unit, Belfast, 
      Northern Ireland.
FAU - McKeever, Karl
AU  - McKeever K
AD  - 1. Royal Belfast Hospital for Sick Children, Pediatric Renal Unit, Belfast, 
      Northern Ireland.
LA  - eng
PT  - Case Reports
DEP - 20151102
PL  - Germany
TA  - Clin Nephrol Case Stud
JT  - Clinical nephrology. Case studies
JID - 101638685
PMC - PMC5437995
OTO - NOTNLM
OT  - HLA DRB15
OT  - anti-GBM
OT  - antiglomerular
OT  - nephrectomy
OT  - pediatric
EDAT- 2015/11/02 00:00
MHDA- 2015/11/02 00:01
PMCR- 2015/11/02
CRDT- 2017/10/19 06:00
PHST- 2015/02/25 00:00 [received]
PHST- 2015/08/26 00:00 [accepted]
PHST- 2017/10/19 06:00 [entrez]
PHST- 2015/11/02 00:00 [pubmed]
PHST- 2015/11/02 00:01 [medline]
PHST- 2015/11/02 00:00 [pmc-release]
AID - 10.5414/CNCS108594 [doi]
PST - epublish
SO  - Clin Nephrol Case Stud. 2015 Nov 2;3:25-30. doi: 10.5414/CNCS108594. eCollection 
      2015.