title: Case report: anti-glomerular basement membrane antibody disease with normal renal function.
abstract: BACKGROUND
  Anti-glomerular basement membrane (GBM) antibody disease is a rare autoimmune disorder characterized by rapidly progressive glomerulonephritis caused by autoantibodies against the α3-chain of type IV collagen in the GBM.
  
  
  METHODS
  An 8-year-old girl with hematuria and proteinuria due to anti-GBM nephritis was diagnosed with hematuria and proteinuria during a school urine screening program. Her blood pressure and serum creatinine levels were normal. Her hematuria and proteinuria persisted for several months. Since a spot urine protein to creatinine ratio was around 7 g/g Cre, a percutaneous renal biopsy was performed. Immunofluorescent staining demonstrated a linear pattern for immunoglobulin G along the entire GBM. Chest computed tomography was normal. Anti-GBM antibody assays were reported as slightly raised; thus, the diagnosis was anti-GBM disease with normal renal function. Treatment included plasma exchange, intravenous high-dose methylprednisolone, and cyclophosphamide as a mainstay medication. The treatment was rapidly effective with an immediate decrease in anti-GBM titers and proteinuria.
  
  
  CONCLUSIONS
  Cases of anti-GBM disease with normal renal function in children are rare. Treatment in children has not been established; therefore, clinicians need to carefully select an effective treatment because the prognosis is poor.
authors.affiliation: Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya City, Aichi Prefecture, 466-8650, Japan. chinanagano@nagoya2.jrc.or.jp.
authors.forename: China
authors.initials: C
authors.lastname: Nagano
authors.affiliation: Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya City, Aichi Prefecture, 466-8650, Japan. ygotoh@nagoya2.jrc.or.jp.
authors.forename: Yoshimitu
authors.initials: Y
authors.lastname: Goto
authors.affiliation: Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya City, Aichi Prefecture, 466-8650, Japan. katsukasa@nifty.com.
authors.forename: Katuaki
authors.initials: K
authors.lastname: Kasahara
authors.affiliation: Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya City, Aichi Prefecture, 466-8650, Japan. kuroyanagi21@hotmail.co.jp.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kuroyanagi
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D006470:Hemorrhage / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007275:Injections, Intravenous; D008171:Lung Diseases / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D008775:Methylprednisolone / Q000008:administration & dosage*; D010951:Plasma Exchange; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone