Anti-glomerular basement membrane disease: Case series from a tertiary center in North India

Anti-glomerular basement (anti-GBM) disease is an uncommon disorder with a bimodal age of presentation. Patients presenting with dialysis-dependent renal failure have poor renal outcomes. There is limited data regarding the clinical presentation and outcomes of anti-GBM disease from India. We conduc...

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Main Authors: D Prabhakar, M Rathi, R Nada, R W Minz, V Kumar, H S Kohli, V Jha, K L Gupta
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Indian Journal of Nephrology
Subjects:
Online Access:http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2017;volume=27;issue=2;spage=108;epage=112;aulast=Prabhakar
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spelling doaj-d62c554c1ea943e6bee36485ded60e7e2020-11-24T20:51:49ZengWolters Kluwer Medknow PublicationsIndian Journal of Nephrology0971-40651998-36622017-01-0127210811210.4103/0971-4065.171227Anti-glomerular basement membrane disease: Case series from a tertiary center in North IndiaD PrabhakarM RathiR NadaR W MinzV KumarH S KohliV JhaK L GuptaAnti-glomerular basement (anti-GBM) disease is an uncommon disorder with a bimodal age of presentation. Patients presenting with dialysis-dependent renal failure have poor renal outcomes. There is limited data regarding the clinical presentation and outcomes of anti-GBM disease from India. We conducted this prospective study to analyze the clinical presentation and outcomes of anti-GBM disease at a large tertiary care hospital in North India over 1½ years. Subjects with a biopsy proven anti-GBM disease (light microscopic examination showing crescents and immunofluorescence examination showing linear deposition of IgG) with or without positive anti-GBM antibodies in serum were included in the study and followed-up for at least 12 months. All the patients were treated with steroids, cyclophosphamide, and plasma exchange. A total of 17 patients (nine males) were included. The mean age at presentation was 39.11 ± 16.58 (range 11–72) years. Twelve patients (70%) presented with rapidly progressive glomerulonephritis (RPGN), 4 (23.5%) presented with Goodpasture syndrome, while 1 (5.8%) had nephritic syndrome, 7 (41%) were hypertensive, and 14 (82.3%) required dialysis at the time of presentation. Four patients (23.5%) had associated anti-neutrophil cytoplasmic antibody positivity (anti-myeloperoxidase antibodies in all). Fourteen (87.5%) patients had crescentic glomerulonephritis, while 5 (31.25%) showed necrotizing (n = 4) or granulomatous (n = 1) in the vasculitis. Of 16 patients who received treatment, four (23.25%) achieved complete remission. In this single-center study, the majority of anti-GBM disease patients presented with RPGN and had crescentic glomerulonephritis on biopsy with poor treatment outcome.http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2017;volume=27;issue=2;spage=108;epage=112;aulast=PrabhakarAnti-glomerular basement diseasecrescentic glomerulonephritisGoodpasture syndromerapidly progressive glomerulonephritis
collection DOAJ
language English
format Article
sources DOAJ
author D Prabhakar
M Rathi
R Nada
R W Minz
V Kumar
H S Kohli
V Jha
K L Gupta
spellingShingle D Prabhakar
M Rathi
R Nada
R W Minz
V Kumar
H S Kohli
V Jha
K L Gupta
Anti-glomerular basement membrane disease: Case series from a tertiary center in North India
Indian Journal of Nephrology
Anti-glomerular basement disease
crescentic glomerulonephritis
Goodpasture syndrome
rapidly progressive glomerulonephritis
author_facet D Prabhakar
M Rathi
R Nada
R W Minz
V Kumar
H S Kohli
V Jha
K L Gupta
author_sort D Prabhakar
title Anti-glomerular basement membrane disease: Case series from a tertiary center in North India
title_short Anti-glomerular basement membrane disease: Case series from a tertiary center in North India
title_full Anti-glomerular basement membrane disease: Case series from a tertiary center in North India
title_fullStr Anti-glomerular basement membrane disease: Case series from a tertiary center in North India
title_full_unstemmed Anti-glomerular basement membrane disease: Case series from a tertiary center in North India
title_sort anti-glomerular basement membrane disease: case series from a tertiary center in north india
publisher Wolters Kluwer Medknow Publications
series Indian Journal of Nephrology
issn 0971-4065
1998-3662
publishDate 2017-01-01
description Anti-glomerular basement (anti-GBM) disease is an uncommon disorder with a bimodal age of presentation. Patients presenting with dialysis-dependent renal failure have poor renal outcomes. There is limited data regarding the clinical presentation and outcomes of anti-GBM disease from India. We conducted this prospective study to analyze the clinical presentation and outcomes of anti-GBM disease at a large tertiary care hospital in North India over 1½ years. Subjects with a biopsy proven anti-GBM disease (light microscopic examination showing crescents and immunofluorescence examination showing linear deposition of IgG) with or without positive anti-GBM antibodies in serum were included in the study and followed-up for at least 12 months. All the patients were treated with steroids, cyclophosphamide, and plasma exchange. A total of 17 patients (nine males) were included. The mean age at presentation was 39.11 ± 16.58 (range 11–72) years. Twelve patients (70%) presented with rapidly progressive glomerulonephritis (RPGN), 4 (23.5%) presented with Goodpasture syndrome, while 1 (5.8%) had nephritic syndrome, 7 (41%) were hypertensive, and 14 (82.3%) required dialysis at the time of presentation. Four patients (23.5%) had associated anti-neutrophil cytoplasmic antibody positivity (anti-myeloperoxidase antibodies in all). Fourteen (87.5%) patients had crescentic glomerulonephritis, while 5 (31.25%) showed necrotizing (n = 4) or granulomatous (n = 1) in the vasculitis. Of 16 patients who received treatment, four (23.25%) achieved complete remission. In this single-center study, the majority of anti-GBM disease patients presented with RPGN and had crescentic glomerulonephritis on biopsy with poor treatment outcome.
topic Anti-glomerular basement disease
crescentic glomerulonephritis
Goodpasture syndrome
rapidly progressive glomerulonephritis
url http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2017;volume=27;issue=2;spage=108;epage=112;aulast=Prabhakar
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