[Case of anti-glomerular basement membrane antibody nephritis in a patient who was able to withdraw from dialysis and gave birth twice but underwent living renal transplantation due to progression to end-stage renal failure 15 years after onset].
A 34-year-old woman with suspected rapidly progressive glomerulonephritis had been admitted to our hospital in March 1993 at the age of 19 years. Renal biopsy revealed cellular crescent formation in 24 of 26 glomeruli. Serum examination was positive for anti-glomerular basement membrane (GBM) antibody, while pulmonary hemorrhage was absent. Based on these findings, she was diagnosed with anti-GBM antibody nephritis, and treated with corticosteroid pulse therapy and double filtration plasmapheresis (DFPP) in addition to hemodialysis (HD). HD was withdrawn within 2 months. Wishing to have a baby, she had delivery in 1997 and 2000. Subsequently, her renal function gradually decreased, and she underwent an ABO-incompatible living-donor kidney transplant, with her husband as the donor, in March 2008. She has been making good progress after transplantation. Anti-GBM antibody nephritis has a poor prognosis, but renal function was maintained for 15 years in this patient, who responded well to the initial treatment. The underlying disease rarely recurs if transplantation is performed after the patient has become negative for anti-GBM antibody, anti-GBM antibody nephritis therefore seems to be a good indication for treating patients with renal transplantation.
Iwamoto
Ichiro
I
Department of Internal Medicine, Iwamoto Clinic, Sakai Hospital, Kinki University School of Medicine, Osaka, Japan.
Naiki
Yoshito
Y
Nose
Kazuhiro
K
Akiyama
Takahiro
T
Sakaguchi
Mika
M
Matsuoka
Toshiaki
T
Samejima
Kenichi
K
Hiroaki
Sato
S
Funauchi
Masanori
M
D000328:Adult; D001323:Autoantibodies; D018450:Disease Progression; D005260:Female; D050533:Glomerular Basement Membrane / Q000276:immunology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D016030:Kidney Transplantation; D008775:Methylprednisolone / Q000008:administration & dosage; D009393:Nephritis / Q000150:complications / Q000628:therapy*; D010951:Plasma Exchange; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D020551:Pulse Therapy, Drug; D006435:Renal Dialysis; D013997:Time Factors
D001323:Autoantibodies; D008775:Methylprednisolone