Anti-glomerular Basement Membrane Glomerulonephritis During the First Trimester of Pregnancy

  • Kai Hirayasu
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Usui Joichi
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Tawara Takashi
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Takahashi-Kobayashi Mayumi
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Ishii Ryota
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Tsunoda Ryoya
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Fujita Akiko
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Nagai Kei
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Kaneko Shuzo
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Morito Naoki
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Saito Chie
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
  • Hamada Hiromi
    Division of Clinical Medicine, Department of Obstetrics & Gynecology, Faculty of Medicine, University of Tsukuba, Japan
  • Yamagata Kunihiro
    Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan

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Abstract

<p>A 28-year-old woman was admitted during the eighth week of her pregnancy because her clinical course was consistent with rapid progressive glomerulonephritis (RPGN). Anti-glomerular basement membrane antibody (anti-GBM Ab) and myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) were positive, and the anti-GBM Ab titer being extremely high. She was treated with hemodialysis, plasma exchange and prednisolone. She survived the illness; however, neither the fetus nor her kidney function could be rescued. She had human leukocyte antigen (HLA)-DRB1*1502:01, which differs from the DRB1*1501 associated with anti-GBM GN. When patients have particular symptoms, we should check the urine and serum creatinine to exclude RPGN, even in cases of pregnancy. </p>

Journal

  • Internal Medicine

    Internal Medicine 60 (5), 765-770, 2021-03-01

    The Japanese Society of Internal Medicine

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