A Case of Idiopathic Membranous Nephropathy with Crescents Formation Associated with Anti-GBM Antibody / 대한신장학회지

ABSTRACT

Crescents formation associated with anti-glomerular basement membrane (anti-GBM) antibody is a rare complication in patients with idiopathic membranous nephropathy (MN). Here, we report a 25-year-old male with crescentic MN associated with anti-GBM antibody, who presented with general edema and decreased renal function. Renal biopsy specimen revealed thickening of the glomerular capillary wall consistent with MN. Of 12 glomeruli, three sclerosed, and two crescents formations with interstitial fibrosis were seen. Serology was positive for anti-GBM antibody with titer of 125 enzyme unit (EU)/mL. The patient was treated with pulse intravenous methylprednisolone for 3 days followed by oral prednisolone, and intravenous cyclophosphamide. His renal function was improved significantly 2 weeks after initiation of treatment. In conclusion, crescents formation should be considered in patients with nephrotic syndrome accompanied with acute renal dysfunction, and the early biopsy of the kidney and appropriate treatment will be required to improve the clinical outcome.