title: Anti-GBM disease with a mild relapsing course and low levels of anti-GBM autoantibodies.
abstract: Anti-glomerular basement membrane disease (anti-GBM) is usually characterized by rapidly progressive glomerulonephritis, and when autoantibody production has ceased, relapses are rare. Here, we report a 71-year-old women diagnosed at a stage of mild renal insufficiency. Over a period of 10 years, she experienced three mild relapses with return of anti-GBM antibodies, haematuria and slight elevations in serum creatinine level. All three relapses responded to immunosuppressive therapy, and all were preceded by peaks of myeloperoxidase-antineutrophil cytoplasm antibodies (MPO-ANCA). This case shows that long-term follow-up is warranted in patients treated for anti-GBM-mediated disease, but urinary dipsticks may be sufficient for early detection of relapses.
authors.affiliation: Division of Drug Research, Department of Medical and Health Sciences , Linköping University , Linköping , Sweden ; Department of Nephrology UHL , County Council of Östergötland , Linköping , Sweden ; Department of Nephrology , Lund University , Lund , Sweden.
authors.forename: Mårten
authors.initials: M
authors.lastname: Segelmark
authors.affiliation: Department of Medicine , NÄL Hospital , Trollhättan , Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Dahlberg
authors.affiliation: Eurodiagnostica AB , Malmö , Sweden.
authors.forename: Jörgen
authors.initials: J
authors.lastname: Wieslander
keywords: Goodpasture's disease; anti-GBM; glomerulonephritis; relapses