Multiple recurrences of anti-glomerular basement membrane disease with variable antibody detection: can the laboratory be trusted?
Anti-glomerular basement membrane (GBM) disease is commonly a monophasic illness. We present the case of multiple recurrences of anti-GBM disease with varying serum anti-GBM antibody findings. A 33-year-old female tobacco user presenting with hematuria was diagnosed with anti-GBM disease by renal biopsy. Five years later, she presented with alveolar hemorrhage and positive anti-GBM antibody. She presented a third time with alveolar hemorrhage but undetectable anti-GBM antibody. With each occurrence, symptoms resolved with plasmapheresis, intravenous methylprednisone and oral cyclophosphamide. The relationship between anti-GBM antibody findings and disease presentation is complex. Clinicians should be aware of the possibility of seronegative anti-GBM disease.
Division of Nephrology, Department of Medicine , University of Wisconsin School of Medicine and Public Health , Madison, WI , USA.
Patricia
P
Liu
Division of Nephrology, Department of Medicine , University of Wisconsin School of Medicine and Public Health , Madison, WI , USA.
Sana
S
Waheed
Division of Nephrology, Department of Medicine , University of Wisconsin School of Medicine and Public Health , Madison, WI , USA.
Lamya
L
Boujelbane
Division of Nephrology, Department of Medicine , University of Wisconsin School of Medicine and Public Health , Madison, WI , USA.
Laura J
LJ
Maursetter
autoantibodies; crescentic glomerulonephritis; glomerulonephritis; plasmapheresis; renal biopsy
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