SARS-CoV-2 infection and recurrence of anti-glomerular basement disease: a case report.
BMC Nephrol
; 22(1): 75, 2021 02 27.
Article
em En
| MEDLINE
| ID: mdl-33639869
ABSTRACT
BACKGROUND:
Anti-glomerular basement membrane disease (GBM) disease is a rare autoimmune disease causing rapidly progressive glomerulonephritis and pulmonary haemorrhage. Recently, an association between COVID-19 and anti-glomerular basement membrane (anti-GBM) disease has been proposed. We report on a patient with recurrence of anti-GBM disease after SARS-CoV-2 infection. CASE PRESENTATION The 31-year-old woman had a past medical history of anti-GBM disease, first diagnosed 11 years ago, and a first relapse 5 years ago. She was admitted with severe dyspnoea, haemoptysis, pulmonary infiltrates and acute on chronic kidney injury. A SARS-CoV-2 PCR was positive with a high cycle threshold. Anti-GBM autoantibodies were undetectable. A kidney biopsy revealed necrotising crescentic glomerulonephritis with linear deposits of IgG, IgM and C3 along the glomerular basement membrane, confirming a recurrence of anti-GBM disease. She was treated with steroids, plasma exchange and two doses of rituximab. Pulmonary disease resolved, but the patient remained dialysis-dependent. We propose that pulmonary involvement of COVID-19 caused exposure of alveolar basement membranes leading to the production of high avidity autoantibodies by long-lived plasma cells, resulting in severe pulmonary renal syndrome.CONCLUSION:
Our case supports the assumption of a possible association between COVID-19 and anti-GBM disease.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença Antimembrana Basal Glomerular
/
COVID-19
Tipo de estudo:
Etiology_studies
Limite:
Child
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Female
/
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article