AUTHOR=Mavani Gaurang P. , Pommier Max , Win Sandar , Michelis Michael F. , Rosenstock Jordan 

TITLE=Presence of Anti-Glomerular Basement Membrane Antibodies and Myeloperoxidase Anti-Neutrophilic Cytoplasmic Antibodies in a Case of Rapidly Progressive Glomerulonephritis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 2 - 2015

YEAR=2015

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2015.00053

DOI=10.3389/fmed.2015.00053

ISSN=2296-858X

ABSTRACT=A 69 year old male developed rapid deterioration of kidney function and developed uremic symptoms. Creatinine was 486.2 µmol/L (5.5 mg/dl) on presentation.  Anti-MPO was positive (titer>8 units, normal <0.4). He was clinically diagnosed with rapidly proliferative glomerulonephritis (RPGN) most likely due to ANCA vasculitis. He received three doses of pulse methylprednisone therapy. Kidney biopsy showed pauci-immune glomerulonephritis. Immunofluoroscence was also positive for faint linear staining of glomerular basement membrane. Anti GBM antibody was positive 2.1U (normal <1). He was started on high dose oral steroids, monthly intravenous cyclophosphamide and plasmapharesis was also initiated. His symptoms improved and creatinine is 247.5 µmol/L (2.8mg/dl). His repeat anti GBM antibody was negative. This is a rare case of rapidly progressive glomerulonephritis due to dual MPO-ANCA antibodies and anti GBM antibodies (DAV).