Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 22, Pages -Publisher
MDPI
DOI: 10.3390/jcm11226793
Keywords
rapidly progressive glomerulonephritis; anti-glomerular basement membrane antibody; perinuclear anti-neutrophil cytoplasmic antibody; rheumatoid arthritis; Sjogren's syndrome
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Funding
- National Natural Science Foundation of China [82170716]
- Graduate Education Innovation Program of Shanxi Province [2021Y357]
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This study reports a case of rapidly progressive glomerulonephritis (RPGN) in a patient with concurrent rheumatoid arthritis (RA) and Sjogren's syndrome (SS), characterized by double positivity in anti-glomerular basement membrane (anti-GBM) antibodies and perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA). The patient showed significant improvement and renal function recovery after aggressive treatment.
Rapidly progressive glomerulonephritis (RPGN) is a life-threatening disease characterized by rapid progressive deterioration of renal function and extensive formation of crescents. Some antibodies tend to be positive, such as a perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) and anti-glomerular basement membrane (anti-GBM) antibodies, in most patients with the disease. However, cases of double positivity for the above antibodies are considered to be rare. In addition, both rheumatoid arthritis (RA) and Sjogren's syndrome (SS) are deemed to be independent immune disorders that can cause renal impairment. Nevertheless, the association between RPGN and these two diseases has not been elucidated in previous studies. Here, we provide a case of RPGN with the concurrence of RA and SS characterized by double positivity in anti-GBM antibodies and p-ANCA. After aggressive treatment with cyclophosphamide, glucocorticoids, and plasma exchange, the patient improved significantly. Despite the malignant event of arteriovenous fistula rupture and bleeding during treatment, the patient survived with renal function recovery for the rest of the follow-up period.
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