TWO PATIENTS WITH ANTI GLOMERULAR BASEMENT MEMBRANE ANTIBODY NEPHRITIS SHOWING POOR PROGNOSIS DESPITE INTENSIVE THERAPY

Abstract

Anti glomerular basement membrane (GBM) nephritis is reported to have a poor prognosis even with intensive immunosuppressive drug therapy. We present two cases of anti-GBM nephritis, exhibiting progressive renal failure without pulmonary lesions and increased serum anti-GBM antibody. Histological examination of renal samples in both cases indicated severe cellular or fibrocellular crescentic glomerulonephritis with a linear deposition of IgG along glomerular capillary walls. Both patients were diagnosed with anti-GBM nephritis. Therapy with steroid pulse treatment, immunosuppressive agents, or plasma exchange was adopted after diagnosis. Both patients suffered unfavorable outcomes, however indicating that renal damage at therapy may be crucial to prognosis.