title: Mesangial IgA deposits indicate pathogenesis of anti-glomerular basement             membrane disease.
abstract: Anti-glomerular basement membrane (anti-GBM) disease is characterized by             crescentic glomerulonephritis with immunoglobulin G (IgG) autoantibodies to the             non-collagenous (NC1) domain of α3(IV) collagen presenting along the GBM. The             patient clinically manifests with rapidly progressive glomerulonephritis (RPGN)             with pulmonary hemorrhage (Goodpasture syndrome). In rare cases, other immunocomplexes             of IgA or IgM are involved, but their specificities have not been determined.             We report a rare case of a 31-year-old female who was diagnosed as having anti-GBM             disease with extensive IgA deposits in the mesangium. This patient presented heavy             hematuria, proteinuria with increasing creatinine, but no lung hemorrhage. Renal             biopsy showed crescentic glomerulonephritis (type Ⅰ) with strong IgA (3+) as lump             and branch shape. Therapies with pulse methylprednisolone, plasmapheresis and             cyclophosphamide administration were less effective. This case is different from             the present type Ⅰ crescentic glomerulonephritis and the specificity of IgA deposits             may implicate the pathogenesis of anti-GBM disease.
authors.affiliation: Institute of Forensic Medicine, Preclinical Medical College, Southern Medical University, Guangzhou, Guangdong, PR China.
authors.forename: Aifeng
authors.initials: A
authors.lastname: Wang
authors.forename: Yongping
authors.initials: Y
authors.lastname: Wang
authors.forename: Guobao
authors.initials: G
authors.lastname: Wang
authors.forename: Zhanmei
authors.initials: Z
authors.lastname: Zhou
authors.forename: Zhang
authors.initials: Z
authors.lastname: Xun
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Tan
mesh_terms: D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D003401:Creatine; D005260:Female; D005920:Glomerular Mesangium / Q000378:metabolism* / Q000473:pathology; D006417:Hematuria / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism*; D011507:Proteinuria / Q000378:metabolism / Q000473:pathology / Q000628:therapy
chemical_list: D007070:Immunoglobulin A; D003401:Creatine