Abstract
Patients with anti-glomerular basement membrane (GBM) antibody glomerulonephritis typically exhibit rapidly progressive glomerulonephritis (RPGN). The renal outcome as well as the prognosis of this disease is worse than other forms of RPGN such as those from microscopic polyangiitis. Therefore, early therapeutic intervention is essential to improve its prognosis. One month before referral to our hospital, a 54-year-old female attended another hospital because of macrohematuria. At that time, she had proteinuria and macrohematuria with normal renal function, was negative for anti-GBM antibodies, and was diagnosed with chronic glomerulonephritis. A month later when she was admitted to our hospital, she showed renal insufficiency and was positive for anti-GBM antibodies. Immediately after recognizing the anti-GBM antibody status, plasma exchange and the first course of steroid pulse therapy was started. After 5 days of therapy, renal biopsy confirmed severe crescentic glomerulonephritis in which all the observed glomeruli were involved with cellular crescents. Despite this, she survived without end-stage renal disease after three courses of steroid pulse therapy and seven sessions of plasma exchange. This favorable outcome reflects the repeated analysis of anti-GBM antibodies within a very short period and the rapid therapeutic intervention in addition to the intensive immunosuppressive therapies.
| Original language | English |
|---|---|
| Pages (from-to) | 25-32 |
| Number of pages | 8 |
| Journal | Case Reports in Nephrology and Dialysis |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
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All Science Journal Classification (ASJC) codes
- Nephrology
Cite this
Rapidly Progressive Glomerulonephritis with Delayed Appearance of Anti-Glomerular Basement Membrane Antibody Successfully Treated with Multiple Courses of Steroid Pulse Therapy. / Toyota, Satoshi; Eriguchi, Masahiro; Hasegawa, Shoko; Ueki, Kenji; Matsukuma, Yuta; Tsuchimoto, Akihiro; Fujisaki, Kiichiro; Torisu, Kumiko; Tsuruya, Kazuhiko; Nakano, Toshiaki; Kitazono, Takanari.
In: Case Reports in Nephrology and Dialysis, Vol. 9, No. 1, 01.01.2019, p. 25-32.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rapidly Progressive Glomerulonephritis with Delayed Appearance of Anti-Glomerular Basement Membrane Antibody Successfully Treated with Multiple Courses of Steroid Pulse Therapy
AU - Toyota, Satoshi
AU - Eriguchi, Masahiro
AU - Hasegawa, Shoko
AU - Ueki, Kenji
AU - Matsukuma, Yuta
AU - Tsuchimoto, Akihiro
AU - Fujisaki, Kiichiro
AU - Torisu, Kumiko
AU - Tsuruya, Kazuhiko
AU - Nakano, Toshiaki
AU - Kitazono, Takanari
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Patients with anti-glomerular basement membrane (GBM) antibody glomerulonephritis typically exhibit rapidly progressive glomerulonephritis (RPGN). The renal outcome as well as the prognosis of this disease is worse than other forms of RPGN such as those from microscopic polyangiitis. Therefore, early therapeutic intervention is essential to improve its prognosis. One month before referral to our hospital, a 54-year-old female attended another hospital because of macrohematuria. At that time, she had proteinuria and macrohematuria with normal renal function, was negative for anti-GBM antibodies, and was diagnosed with chronic glomerulonephritis. A month later when she was admitted to our hospital, she showed renal insufficiency and was positive for anti-GBM antibodies. Immediately after recognizing the anti-GBM antibody status, plasma exchange and the first course of steroid pulse therapy was started. After 5 days of therapy, renal biopsy confirmed severe crescentic glomerulonephritis in which all the observed glomeruli were involved with cellular crescents. Despite this, she survived without end-stage renal disease after three courses of steroid pulse therapy and seven sessions of plasma exchange. This favorable outcome reflects the repeated analysis of anti-GBM antibodies within a very short period and the rapid therapeutic intervention in addition to the intensive immunosuppressive therapies.
AB - Patients with anti-glomerular basement membrane (GBM) antibody glomerulonephritis typically exhibit rapidly progressive glomerulonephritis (RPGN). The renal outcome as well as the prognosis of this disease is worse than other forms of RPGN such as those from microscopic polyangiitis. Therefore, early therapeutic intervention is essential to improve its prognosis. One month before referral to our hospital, a 54-year-old female attended another hospital because of macrohematuria. At that time, she had proteinuria and macrohematuria with normal renal function, was negative for anti-GBM antibodies, and was diagnosed with chronic glomerulonephritis. A month later when she was admitted to our hospital, she showed renal insufficiency and was positive for anti-GBM antibodies. Immediately after recognizing the anti-GBM antibody status, plasma exchange and the first course of steroid pulse therapy was started. After 5 days of therapy, renal biopsy confirmed severe crescentic glomerulonephritis in which all the observed glomeruli were involved with cellular crescents. Despite this, she survived without end-stage renal disease after three courses of steroid pulse therapy and seven sessions of plasma exchange. This favorable outcome reflects the repeated analysis of anti-GBM antibodies within a very short period and the rapid therapeutic intervention in addition to the intensive immunosuppressive therapies.
UR - http://www.scopus.com/inward/record.url?scp=85064933659&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85064933659&partnerID=8YFLogxK
U2 - 10.1159/000499401
DO - 10.1159/000499401
M3 - Article
AN - SCOPUS:85064933659
VL - 9
SP - 25
EP - 32
JO - Case Reports in Nephrology and Dialysis
JF - Case Reports in Nephrology and Dialysis
SN - 2296-9705
IS - 1
ER -