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A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining

Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disorder characterized by the production of circulating immunoglobulin G (IgG) antibodies that affect the kidneys and lungs, mainly in the form of rapidly progressive crescentic glomerulonephritis and pulmonary hemorrhage. Typical...

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Autores principales: Faisal, Mohannad, Shams, Abdullah, Archichige, Suresh, Hamdi, Ahmed, Akhtar, Mohammed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9179943/
https://www.ncbi.nlm.nih.gov/pubmed/35702466
http://dx.doi.org/10.7759/cureus.24879
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author Faisal, Mohannad
Shams, Abdullah
Archichige, Suresh
Hamdi, Ahmed
Akhtar, Mohammed
author_facet Faisal, Mohannad
Shams, Abdullah
Archichige, Suresh
Hamdi, Ahmed
Akhtar, Mohammed
author_sort Faisal, Mohannad
collection PubMed
description Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disorder characterized by the production of circulating immunoglobulin G (IgG) antibodies that affect the kidneys and lungs, mainly in the form of rapidly progressive crescentic glomerulonephritis and pulmonary hemorrhage. Typically diagnosed on tissue biopsy, findings mainly include glomerular crescent formation, bright linear staining of GBM for IgG on direct immunofluorescence (IF), and the serologic presence of circulating anti-GBM antibodies. Variation in the laboratory results, where histological findings of linear IgG IF staining were present in the absence of circulating anti-GBM antibodies, have recently led to the use of the term “atypical anti-GBM disease,” which usually has a distinct benign clinical outcome as compared to typical anti-GBM disease. We report a case of a middle-aged woman who presented with renal failure without lung involvement. Upon further investigation, the patient was found to have strongly positive serum anti-GBM antibodies, but the tissue biopsy did not show typical findings of the anti-GBM disease. The patient showed modest improvement after multiple sessions of plasmapheresis and steroids, with stabilization of her renal parameters after the initial response. In our case, we will address the possibilities of the discrepancies between the serological and histopathological findings.
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spelling pubmed-91799432022-06-13 A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining Faisal, Mohannad Shams, Abdullah Archichige, Suresh Hamdi, Ahmed Akhtar, Mohammed Cureus Pathology Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disorder characterized by the production of circulating immunoglobulin G (IgG) antibodies that affect the kidneys and lungs, mainly in the form of rapidly progressive crescentic glomerulonephritis and pulmonary hemorrhage. Typically diagnosed on tissue biopsy, findings mainly include glomerular crescent formation, bright linear staining of GBM for IgG on direct immunofluorescence (IF), and the serologic presence of circulating anti-GBM antibodies. Variation in the laboratory results, where histological findings of linear IgG IF staining were present in the absence of circulating anti-GBM antibodies, have recently led to the use of the term “atypical anti-GBM disease,” which usually has a distinct benign clinical outcome as compared to typical anti-GBM disease. We report a case of a middle-aged woman who presented with renal failure without lung involvement. Upon further investigation, the patient was found to have strongly positive serum anti-GBM antibodies, but the tissue biopsy did not show typical findings of the anti-GBM disease. The patient showed modest improvement after multiple sessions of plasmapheresis and steroids, with stabilization of her renal parameters after the initial response. In our case, we will address the possibilities of the discrepancies between the serological and histopathological findings. Cureus 2022-05-10 /pmc/articles/PMC9179943/ /pubmed/35702466 http://dx.doi.org/10.7759/cureus.24879 Text en Copyright © 2022, Faisal et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pathology
Faisal, Mohannad
Shams, Abdullah
Archichige, Suresh
Hamdi, Ahmed
Akhtar, Mohammed
A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining
title A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining
title_full A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining
title_fullStr A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining
title_full_unstemmed A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining
title_short A Case Report of Crescentic Glomerulonephritis With Positive Serum Anti-glomerular Basement Membrane Without Linear Glomerular Basement Membrane Immunofluorescent Staining
title_sort case report of crescentic glomerulonephritis with positive serum anti-glomerular basement membrane without linear glomerular basement membrane immunofluorescent staining
topic Pathology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9179943/
https://www.ncbi.nlm.nih.gov/pubmed/35702466
http://dx.doi.org/10.7759/cureus.24879
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