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- Title
Monotypic IgG1-kappa Atypical Anti-Glomerular Basement Membrane Nephritis: A Case Report.
- Authors
Olivier, Maxim; Watson, Harold; Lee, Danielle; Mohanlal, Viresh; Madruga, Mario; Carlan, Steven
- Abstract
Anti-glomerular basement membrane (anti-GBM) glomerulonephritis is a rare disease caused by autoantibodies against the glomerular basement membrane. Atypical anti-GBM nephritis is clinically less aggressive and characterized by the absence of circulating autoantibodies to the basement membrane. A previously healthy 53-year-old white woman presented with a rising creatinine over a short observation period. Renal biopsy, urinary sediment, and laboratory testing confirmed the diagnosis of atypical anti-GBM disease. She received plasmapheresis, steroids, and cyclophosphamide. She developed hemorrhagic cystitis early in the treatment from oral cyclophosphamide and mycophenolate mofetil was substituted as a first-line drug. She responded favorably and continued on mycophenolate mofetil without evidence of relapse. Despite the absence of circulating autoantibodies, a diagnosis of atypical anti-GBM nephritis should not be excluded if a high index of clinical suspicion exists. Early renal biopsy should be considered. Mycophenolate mofetil may be a reasonable replacement for oral cyclophosphamide in the treatment of atypical anti-GBM disease when cyclophosphamide is contraindicated.
- Subjects
BASAL lamina; NEPHRITIS; THERAPEUTICS; MYCOPHENOLIC acid; RENAL biopsy; URINALYSIS
- Publication
Case Reports in Nephrology & Dialysis, 2019, Vol 9, Issue 1, p8
- ISSN
2296-9705
- Publication type
Article
- DOI
10.1159/000498844