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. 2012 Dec;5(6):549-51.
doi: 10.1093/ckj/sfs098. Epub 2012 Oct 5.

Anti-GBM disease with a mild relapsing course and low levels of anti-GBM autoantibodies

Mårten Segelmark  1 , Per Dahlberg  2 , Jörgen Wieslander  3
Affiliations

Anti-GBM disease with a mild relapsing course and low levels of anti-GBM autoantibodies

Mårten Segelmark et al. Clin Kidney J. 2012 Dec.

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.

Keywords: Goodpasture's disease; anti-GBM; glomerulonephritis; relapses.

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Figures

Fig. 1.
Fig. 1.
The solid line represents levels of anti-GBM antibodies measured by the enzyme-linked immunosorbent assay (ELISA) and expressed in arbitrary ELISA units as indicated by the right vertical axis. The patient exhibited four distinct serological exacerbations separated by intervals with negative tests. The serological relapses coincided with clinical relapses; start (and restart) of immunosuppressive treatment is indicated by arrows. Dotted lines represent MPO-ANCA levels measured by three different ELISA methods. Method* was used until June 2007, then method** was used until November the same year when method***, using international units, was introduced. ELISA units for MPO-ANCA are indicated on the left vertical axis, levels differ between the three assays.
See this image and copyright information in PMC

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