The increase of antiglomerular basement membrane antibody following pauci-immune-type crescentic glomerulonephritis.

Abstract	A 50-year-old woman was admitted because of high fever and fatigue. Proteinuria, hematuria, and elevated BUN (47.8 mg/dl) and creatinine (3.4 mg/dl) suggested rapidly progressive glomerulonephritis. The serological study revealed all negative results for rheumatoid factor, antinuclear antibody, serum cryoglobulins, MPO-ANCA, PR3-ANCA, and anti-streptolysin O. Antiglomerular basement membrane (GBM) antibody, as assessed by ELISA, was 11 EU (normal, <10). Kidney biopsy on the eighth hospital day demonstrated pauci-immune-type crescentic glomerulonephritis without ANCA. Methylprednisolone pulse therapy (500 mg/day, 3 days) and 45 mg/day prednisolone orally were started. At 3 weeks after kidney biopsy, the anti-GBM antibody value increased from 11 EU/ml to 116 EU/ml, and MPO and PR3-ANCA were still negative. HLA type was DR8 and DR 15(2), with a genotype of HLA-DRB108021 and HLA-DRB115011. The present case suggests that HLA-DR15 plays an important role on antibody production against alpha 3(IV) NC1 autoantigen after severe nephritis or tissue damage.
Authors	Wataru Kitagawa, Naoto Miura, Harutaka Yamada, Kazuhiro Nishikawa, Arao Futenma, Hirokazu Imai
Journal	Clinical and experimental nephrology (Clin Exp Nephrol) Vol. 9 Issue 1 Pg. 69-73 (Mar 2005) ISSN: 1342-1751 [Print] Japan
PMID	15830277 (Publication Type: Case Reports, Journal Article)
Chemical References	Anti-Inflammatory Agents Antibodies Autoantibodies Glucocorticoids HLA-DR Antigens HLA-DR Serological Subtypes HLA-DR15 antigen antiglomerular basement membrane antibody Prednisolone Methylprednisolone
Topics	Anti-Inflammatory Agents (adverse effects, therapeutic use) Antibodies (blood) Autoantibodies Drug Therapy, Combination Female Glomerulonephritis (diagnostic imaging, drug therapy, immunology, pathology) Glucocorticoids (adverse effects, therapeutic use) HLA-DR Antigens (blood) HLA-DR Serological Subtypes Humans Methylprednisolone (therapeutic use) Middle Aged Prednisolone (adverse effects, therapeutic use) Radionuclide Imaging

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