Triple hit to the kidney-dual pathological crescentic glomerulonephritis and diffuse proliferative immune complexmediated glomerulonephritis: A case report  

作　　者：Dalia Ibrahim Sergey V Brodsky Anjali A Satoskar Laura Biederman Natallia Maroz 

机构地区：[1]Department of Pathology,Ohio State University,Columbus,OH 43210,United States [2]Department of Medicine,Wright State University,Dayton,OH 45409,United States

出　　处：《World Journal of Clinical Cases》2022年第32期11869-11876,共8页世界临床病例杂志

摘　　要：BACKGROUND Anti-glomerular basement membrane(GBM)disease is a rare rapidly progressive glomerulonephritis,frequently associated with alveolar hemorrhage in the lungs and involving the kidney by crescentic glomerulonephritis.It has been described in association with other glomerulonephritides[such as anti-neutrophilic antibody(ANCA)-glomerulonephritis,membranous nephropathy,and immunoglobulin(Ig)A nephropathy].CASE SUMMARY Herein we present an unusual case of concurrent anti-GBM disease,ANCAassociated crescentic glomerulonephritis and diffuse proliferative immune complex mediated glomerulonephritis with predominant staining for IgA and C3 by immunofluorescence.The patient is a 46-year-old Caucasian male who presented to the emergency department with acute onset of flank pain and was found to have high serum creatinine levels of 15 mg/dL,proteinuria,and hematuria.He rapidly deteriorated and became anuric.He was found to have high anti-GBM antibodies titers(151 units)and high anti-neutrophil cytoplasmic-ANCA.Despite prompt and early treatment,the patient’s condition worsened,and he succumbed to his illness.CONCLUSION Our case emphasizes the importance of a renal biopsy in anti-GBM disease,even in the presence of positive serum anti-GBM antibodies,to identify other potential causes of rapidly progressive glomerulonephritis.The challenge in treating such cases lies in the different therapy modalities.

关 键 词：Anti-glomerular basement membrane disease Anti-neutrophilic antibody-associated glomerulonephritis Diffuse proliferative glomerulone-phritis Immune complex mediated glomerulonephritis Case report 

分 类 号：R692.31[医药卫生—泌尿科学]