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

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

Author Monteiro, Eduardo José Bellotto Autor UNIFESP Google Scholar
Caron, Daiane Autor UNIFESP Google Scholar
Balda, Carlos Alberto Autor UNIFESP Google Scholar
Franco, Marcello Fabiano de Autor UNIFESP Google Scholar
Pereira, Aparecido Bernardo Autor UNIFESP Google Scholar
Mastroianni Kirsztajn, Gianna Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
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.
Keywords Anti-GBM glomerulonephritis
HIV
urinary abnormalities
Language English
Date 2006-02-01
Published in Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 10, n. 1, p. 55-58, 2006.
ISSN 1413-8670 (Sherpa/Romeo)
Publisher Brazilian Society of Infectious Diseases
Extent 55-58
Origin http://dx.doi.org/10.1590/S1413-86702006000100011
Access rights Open access Open Access
Type Article
SciELO ID S1413-86702006000100011 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/2908

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