TAILIEUCHUNG - Báo cáo y học: "Anti-glomerular basement membrane disease superimposed on membranous nephropathy: a case report and review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Anti-glomerular basement membrane disease superimposed on membranous nephropathy: a case report and review of the literature. | Patel et al. Journal of Medical Case Reports 2010 4 237 http content 4 1 237 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Anti-glomerular basement membrane disease superimposed on membranous nephropathy a case report and review of the literature Dhruval Patel1 Noel Nivera1 Allan R Tunkel1 2 Abstract Introduction Anti-glomerular basement membrane disease is a rare autoimmune disorder characterized by pulmonary hemorrhage crescentic glomerulonephritis and the presence of circulating anti-glomerular basement membrane antibodies. The simultaneous occurrence of both anti-glomerular basement membrane disease and membranous nephropathy is rare. Case presentation A 59-year-old Hispanic man presented with acute onset of nausea and vomiting and was found to have renal insufficiency. Work-up included a kidney biopsy which revealed anti-glomerular basement membrane disease with underlying membranous nephropathy. He was treated with emergent hemodialysis intravenous corticosteroids plasmapheresis and cyclophosphamide without improvement in his renal function. Conclusion Simultaneous anti-glomerular basement membrane disease and membranous nephropathy is very rare. There have been 16 previous case reports in the English language literature that have been associated with a high mortality and morbidity and a very high rate of renal failure resulting in hemodialysis. Co-existence of membranous nephropathy and anti-glomerular basement membrane disease may be immune-mediated although the exact mechanism is not clear. Introduction Anti-glomerular basement membrane anti-GBM disease is a rare autoimmune disorder with significant morbidity and mortality and is characterized by pulmonary hemorrhage crescentic glomerulonephritis and the presence of circulating anti-GBM antibodies which bind to the alpha-3 chain of type 4 collagen found in the glomerular and alveolar basement membranes 1 . The etiology of anti-GBM disease is unclear but may .

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