Anti-glomerular basement membrane glomerulonephritis in an HIV positive patient: case report



Document title: Anti-glomerular basement membrane glomerulonephritis in an HIV positive patient: case report
Journal: The brazilian journal of infectious diseases
Database: PERIÓDICA
System number: 000291022
ISSN: 1413-8670
Authors: 1
2

3

Institutions: 1Universidade Federal de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil
2Universidade Federal de Sao Paulo, Servicio de Nefrologia, Sao Paulo. Brasil
3Universidade Federal de Sao Paulo, Departamento de Patologia, Sao Paulo. Brasil
Year:
Season: Feb
Volumen: 10
Number: 1
Pages: 55-58
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Caso clínico
English abstract We report on a case of a patient with HIV infection, diagnosed 18 months prior to the development of an anti-glomerular basement membrane (anti-GBM) rapidly progressive glomerulonephritis; this is probably the first report of such an association. A 30-year-old white man presented with elevation of serum creatinine (1.3 - 13.5 mg/dL within one month). At admission, the urinalysis showed proteinuria of 7.2 g/L and 8,000,000 erythrocytes/mL. Renal biopsy corresponded to a crescentic diffuse proliferative glomerulonephritis mediated by anti-GBM, and serum testing for anti-GBM antibodies was positive; antinuclear antibodies (ANA) and anti-neutrophilic cytoplasmic antibodies (ANCA) were also positive. The patient underwent hemodyalisis and was treated with plasmapheresis, cyclophosphamide and prednisone. The association described here is not casual, as crescentic glomerulonephritis is not common in HIV-positive patients, anti-GBM glomerulonephritis is rare and anti-GBM antibodies are frequently observed in HIV-positive subjects when compared to the overall population. Based on the current case and on the elevated frequency of the positivity for such antibodies in this group of patients, it is advisable to be aware of the eventual association between these two conditions and to promote an active search for anti-GBM antibodies and early diagnosis of eventual urinary abnormalities in HIV-positive subjects, considering the severity of anti-GBM glomerulonephritis
Disciplines: Medicina
Keyword: Nefrología,
Inmunología,
Glomerulonefritis,
VIH,
Vías urinarias,
Anticuerpos
Keyword: Medicine,
Nephrology,
Glomerulonephritis,
HIV,
Urinary tract,
Antibodies,
Immunology
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