PMID- 34011133
OWN - NLM
STAT- MEDLINE
DCOM- 20210601
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 20
DP  - 2021 May 21
TI  - Anti-glomerular basement membrane disease associated with thin basement membrane 
      nephropathy: A case report.
PG  - e26095
LID - 10.1097/MD.0000000000026095 [doi]
LID - e26095
AB  - RATIONALE: Simultaneous occurrence of anti-glomerular basement membrane 
      (anti-GBM) disease and thin basement membrane nephropathy (TBMN), both of which 
      invade the type IV collagen subunits, is very rare. Here, we present the case of 
      a 20-year-old male patient diagnosed with both anti-GBM disease and TBMN upon 
      presenting dyspnea and hemoptysis. PATIENT CONCERNS: No laboratory abnormalities, 
      except arterial hypoxemia (PaO275.4 mmHg) and microscopic hematuria, were 
      present. Chest computed tomography revealed bilateral infiltrations in the lower 
      lung fields; thus, administration of empirical antibiotics was initiated. Gross 
      hemoptysis persisted nonetheless, and bronchoscopy revealed diffuse pulmonary 
      hemorrhage with no endobronchial lesions. Broncho-alveolar lavage excluded 
      bacterial pneumonia, tuberculosis, and fungal infection. DIAGNOSIS: Enzyme-linked 
      immunosorbent assay of his serum was positive for anti-GBM antibody (95.1 U/mL). 
      Human leukocyte antigen (HLA) test was positive for both HLA-DR15/-DR04. Other 
      than diffuse thinning of the GBM (average thickness, 220 nm), index kidney biopsy 
      did not demonstrate any specific abnormalities such as crescent formation. 
      INTERVENTIONS: Methylprednisolone was administered intravenously for 7 
      consecutive days (500 mg/day), followed by the daily dose of oral prednisolone 
      (80 mg). Cyclophosphamide was also orally administered every day for 3 months 
      (250 mg/day). Following 6 sessions of plasmapheresis, the anti-GBM antibody in 
      serum became negative. OUTCOMES: There was no clinical evidence suggesting 
      recurrence of pulmonary hemorrhage or azotemia during hospitalization and 
      12-month follow-up period. Twelve months after hospital discharge, oral 
      prednisolone was discontinued. LESSONS: The patients with concurrent anti-GBM 
      disease and TBMN will have a favorable prognosis after proper therapy. However, 
      further research is needed to elucidate the pathogenesis and long-term outcome of 
      the comorbidity of these 2 diseases.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Jung, Chi Young
AU  - Jung CY
AD  - Department of Internal Medicine.
FAU - Lee, Sun-Jae
AU  - Lee SJ
AD  - Department of Pathology, Daegu Catholic University School of Medicine, Daegu.
FAU - Kim, Min-Kyung
AU  - Kim MK
AD  - Department of Pathology, Dongguk University College of Medicine, Gyeongju.
FAU - Ahn, Dong Jik
AU  - Ahn DJ
AD  - Department of Internal Medicine, HANSUNG Union Internal Medicine Clinic and 
      Dialysis Center, Daegu, Republic of Korea.
FAU - Lee, In Hee
AU  - Lee IH
AUID- ORCID: 0000-0003-3562-7586
AD  - Department of Internal Medicine.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Anti-Glomerular Basement Membrane Disease/*complications/*diagnosis/therapy
MH  - Glomerular Basement Membrane/diagnostic imaging/pathology
MH  - Humans
MH  - Kidney Diseases/*complications/diagnosis/therapy
MH  - Male
MH  - Young Adult
PMC - PMC8137055
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2021/05/21 06:00
MHDA- 2021/06/02 06:00
PMCR- 2021/05/21
CRDT- 2021/05/20 01:01
PHST- 2021/03/17 00:00 [received]
PHST- 2021/05/06 00:00 [accepted]
PHST- 2021/05/20 01:01 [entrez]
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2021/06/02 06:00 [medline]
PHST- 2021/05/21 00:00 [pmc-release]
AID - 00005792-202105210-00114 [pii]
AID - MD-D-21-02096 [pii]
AID - 10.1097/MD.0000000000026095 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 May 21;100(20):e26095. doi: 
      10.1097/MD.0000000000026095.