Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2011, Vol. 33 ›› Issue (4): 432-435.doi: 10.3881/j.issn.1000-503X.2011.04.016

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Clinical Analysis of Anti glomerular Basement Membrane Disease with Normal Renal Function

MOU Li-jun, CHEN Li-meng, ZUO Lai-meng, WANG Hai-yun, TAO Jian-ling,WEN Yu-bing, YE Wen-ling, QIN Yan, LI Hang, LI Xue-mei, LI Xue-wang   

  1. Department of Nephrology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2010-09-27 Revised:2011-09-05 Online:2011-08-01 Published:2011-08-01
  • Contact: CHEN Li-meng

Abstract: Objective To investigate the clinical and pathologic characteristics of anti-glomerular basement membrane(GBM) disease with normal renal function. Methods The clinical and pathologic data of 6 patients with anti-GBM disease and normal renal function in Peking Union Medical College Hospital were reviewed retrospectively. Furthermore, 29 patients with anti-GBM disease and impaired renal function in the same period in the same hospital were enrolled as the control group. Factors that may influence the prognosis were analyzed. Results Six (17.1%) of all 35 patients maintained normal renal function for 12-133 months during follow-up. Five patients had microhematuria and proteinuria, one had pulmonary hemorrhage only, and three manifested as Goodpasture syndrome. Renal biopsies from 4 patients revealed linear deposition of IgG 2+-3+ along the glomerular capillary walls by immunofluorescence. As shown by normal light microscopy, mild mesangial proliferation and crescentic glomerulonephritis with a large amount of fibrinoid necrosis of glomerular capillary walls were observed in different patients; however, most pathological changes were mild. Five of these six patients were treated with immunosuppressive drugs and/or plasma exchange. Compared with the control group, the 6 patients with normal renal function had significantly higher hemoglobin[(77.97±20.62)vs.(99.67±19.80)g/L,P=0.024], lower titers of anti-GBM antibody[(224.34±145.79)vs.(80.23±85.73)EU/ml,P=0.027], and lower ratio of glomeruli with crescents[(0.58±0.29)vs.(0.17±0.27),P=0.005]. These 6 patients with normal renal function were followed up for 12-133 months, among whom 4 patients achieved complete remission and 2 had mild proteinuria and microhematuria.Conclusion sAnti-GBM disease with normal renal function is not uncommon. Most patients have mild pathologic changes and good prognosis."

Key words: anti-glomerular basement membrane antibody , normal renal function, pulmonary hemorrhage

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