title: [An experience of treatment of double positive myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO-ANCA) and anti-glomerular basement membrane antibodies in Goodpasture's syndrome onset of crescentic glomerulonephritis].
abstract: A 68-year-old woman was admitted to Kinki University Hospital because of progressive renal failure. She had been well until two months before admission. Laboratory data were as follows: serum creatinine 4.1 mg/dl, BUN 69 mg/dl, MPO-ANCA 33 EU, anti-glomerular basement membrane antibodies (AGBMA) 118 U. Histological findings showed cellular and fibrocellular crescents in many glomeruli. Therefore, we diagnosed rapidly progressive glomerulonephritis (RPGN) due to MPO-ANCA and anti-GBM associated renal disease. The patient was started on prednisolone and double filtration plasmapheresis (DFPP) therapy. Subsequently, the values of MPO-ANCA and AGBMA decreased. However, the patient's condition suddenly worsened and she died of interstitial pneumonia. Autopsy examination revealed crescentic glomerulonephritis and alveolar hemorrhage with linear deposition of IgG along the glomerular and alveolar capillary walls by immunofluorescence studies. We considered this to be a rare case of Goodpasture's syndrome associated with not only anti-GBM antibodies, but also MPO-ANCA.
authors.affiliation: Third Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Takeda
authors.forename: T
authors.initials: T
authors.lastname: Takeda
authors.forename: Y
authors.initials: Y
authors.lastname: Naiki
authors.forename: S
authors.initials: S
authors.lastname: Yonekawa
authors.forename: M
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: I
authors.initials: I
authors.lastname: Iwamoto
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Hasegawa
authors.forename: A
authors.initials: A
authors.lastname: Imada
authors.forename: A
authors.initials: A
authors.lastname: Kanamaru
authors.forename: S
authors.initials: S
authors.lastname: Hiruma
authors.forename: S
authors.initials: S
authors.lastname: Maekura
authors.forename: S
authors.initials: S
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Yamazumi
mesh_terms: D000368:Aged; D019867:Anti-Glomerular Basement Membrane Disease / Q000276:immunology / Q000628:therapy*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000906:Antibodies / Q000032:analysis*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D001323:Autoantibodies; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology* / Q000276:immunology; D006801:Humans; D009195:Peroxidase / Q000276:immunology*; D010956:Plasmapheresis; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D000906:Antibodies; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; C051951:antiglomerular basement membrane antibody; D011239:Prednisolone; D009195:Peroxidase