title: IgA variant of anti-glomerular basement membrane glomerulonephritis associated with pulmonary hemorrhage and microangiopathic hemolytic anemia.
abstract: A 70-year-old man with uremia was referred because of hemoptysis. A chest X-ray showed diffuse infiltration in the right lung field. Laboratory data were remarkable for renal failure, anemia, and thrombocytopenia. Furthermore, laboratory evidence of microangiopathic hemolytic anemia was present. A kidney biopsy revealed diffuse crescentic glomerulonephritis with linear staining of IgA along the glomerular basement membrane (GBM). No thrombotic microangiopathy was noted on renal biopsy. Circulating IgG anti-GBM antibody was not detected, and IgA anti-GBM antibody was not tested. The patient was treated with plasmapheresis and pulse steroid therapy, which resulted in an immediate improvement in the pulmonary hemorrhage and hematological abnormalities. However, the patient did not regain renal function and remained on hemodialysis.
authors.affiliation: Division of Nephrology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chih-Lin
authors.initials: CL
authors.lastname: Ke
authors.forename: Yao-Ko
authors.initials: YK
authors.lastname: Wen
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Chen
mesh_terms: D000368:Aged; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology*; D001485:Basement Membrane / Q000276:immunology; D001706:Biopsy; D003937:Diagnosis, Differential; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007678:Kidney Glomerulus / Q000276:immunology / Q000473:pathology; D008297:Male; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis / Q000209:etiology*; D013902:Radiography, Thoracic
chemical_list: D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies; D007074:Immunoglobulin G; C048844:anti-IgG; C051951:antiglomerular basement membrane antibody