A Case of Membranoproliferative Glomerulonephritis with False-Positive Reaction for Anti-GBM Antibody / 대한신장학회지
Korean Journal of Nephrology
;
: 480-484, 2009.
Article
in Korean
| WPRIM
| ID: wpr-158408
ABSTRACT
Anti-glomerular basement membrane (Anti-GBM) nephritis is an autoimmune disorder characterized by rapidly progressive crescentic glomerulonephritis (RPGN). The treatment of anti-GBM nephritis with plasmapheresis, steroids and immunosuppressant has improved outcomes. An early diagnosis is essential for the survival of patients and a recovery of renal function. The diagnosis of anti-GBM disease has been traditionally based on the demonstration of linear deposits of immunoglobulins along the glomerular basement membrane by immunofluorescence (IF) microscopy. However, a kidney biopsy cannot always be easily performed in such ill patients. Recent development of specific enzyme immunoassays for anti-GBM antibody in the serum has made possible a provisional diagnosis without a kidney biopsy. A 46-year-old male patient with hypertension and hepatitis B presented with generalized edema and general weakness. Laboratory findings were compatible with acute renal failure and nephrotic syndrome with positive serum anti-GBM antibodies. After plasmapheresis with steroid pulse therapy, renal biopsy was performed and diagnosed as membranoproliferative glomerulonephritis (MPGN) with granular deposit of Ig G and C3. Follow-up antibody titers were negative. This case demonstrates the possibility of false-positive anti-GBM antibody in the serum. Therefore, enzyme immunoassay for anti-GBM antibody should be used only as a screening or follow-up test in patients that have been confirmed positive by IF microscopy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Autoantibodies
/
Steroids
/
Basement Membrane
/
Biopsy
/
Immunoglobulins
/
Glomerulonephritis, Membranoproliferative
/
Mass Screening
/
Follow-Up Studies
/
Fluorescent Antibody Technique
/
Immunoenzyme Techniques
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Screening study
Limits:
Humans
/
Male
Language:
Korean
Journal:
Korean Journal of Nephrology
Year:
2009
Type:
Article
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