Anti-glomerular basement membrane glomerulonephritis with subsequent pulmonary hemorrhage in the course of pulmonary tuberculosis.

Abstract

A 66-year-old man with uremia and on hemodialysis was referred to our hospital because of hemoptysis. A chest radiograph showed diffuse infiltration in the right lung field. Laboratory data were remarkable for renal failure accompanied by hematuria and proteinuria. A kidney biopsy revealed diffuse crescentic glomerulonephritis with linear staining of IgG along the glomerular basement membrane (GBM). Circulating IgG anti-GBM antibody was not detected. Because the findings of renal biopsy suggested anti-GBM disease, the patient was treated with plasmapheresis and pulse steroid therapy, which resulted in a rapid resolution of his pulmonary symptoms and chest radiograph abnormalities. However, sputum culture submitted on admission yielded Mycobacterium tuberculosis 3 weeks later. Therefore, immunosuppressive agents were discontinued and antituberculous agents were administrated. No relapse of pulmonary hemorrhage occurred during the next 1-year period of follow-up, but the patient did not regain renal function and remained on hemodialysis.

• Authors: Yao-Peng Hsieh, Yao-Ko Wen
• Journal: Renal failure (Ren Fail) Vol. 34 Issue 9 Pg. 1177-80 ( 2012) ISSN: 1525-6049 [Electronic] England
• PMID: 22950833 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Anti-Idiotypic
• Autoantibodies
• antiglomerular basement membrane antibody

Topics

• Aged
• Anti-Glomerular Basement Membrane Disease (complications, diagnosis)
• Antibodies, Anti-Idiotypic (analysis)
• Autoantibodies (analysis)
• Biopsy
• Diagnosis, Differential
• Hemoptysis (diagnosis, etiology)
• Humans
• Kidney Glomerulus (immunology, pathology)
• Male
• Mycobacterium tuberculosis (isolation & purification)
• Radiography, Thoracic
• Sputum (microbiology)
• Tuberculosis, Pulmonary (complications, diagnosis, immunology)