Coexistence of anti-glomerular basement membrane disease and IgA nephropathy: an illustrative case and comprehensive literature review

Abstract

Anti-glomerular basement membrane (GBM) disease is a rare autoimmune condition characterized by the presence of positive anti-GBM autoantibodies, linear deposition of immunoglobulin G (IgG) along the GBM and severe kidney injury. In a limited number of cases, the association of anti-GBM disease with other glomerulonephritis has been reported. Herein, we present the case of a 66-year-old female patient with progressive worsen kidney function and decreased urine output. A renal biopsy revealed crescent glomerulonephritis with lineal IgG deposition along the GBM and mesangial IgA deposition, which supported the diagnosis of concurrent anti-GBM disease and IgA nephropathy (IgAN). In an extensive literature review, we identified a total of thirty-nine patients were reported anti-GBM disease combined with IgAN. The clinical characteristics of these patients demonstrate that the anti-GBM disease combined with IgAN tends to be milder with a more indolent course and a better prognosis than the classic anti-GBM disease, and its potential pathogenesis deserves to be further explored.

Keywords:

• Anti-glomerular basement membrane disease
• IgA nephropathy
• crescentic glomerulonephritis
• immunoglobulin G
• prognosis

Acknowledgements

The authors appreciate the patient for her patience and cooperation in the diagnostic work-up and follow-up.

Authors’ contributions

Zewei Chen, Dechao Xu, and Fangzheng Cui were involved in the patient case, collected the necessary data, and drafted and finalized the manuscript. Xiang Gao and Huihui Hou was involved in the patient case, delivered the necessary data, and critically revised the manuscript for intellectual content. Xiang Gao and Zhiguo Mao were accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved. All authors contributed to the article and approved the submitted version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by research Grants 20234Y0175 from the Clinical Research Project of Shanghai Municipal Health Commission, 22Y11905500 from the Science and Technology Innovation Plan of Shanghai Science and Technology Commission, 82070705 from the National Natural Science Foundation of China.