Abstract
Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by progressive loss of renal function in a short period. At renal biopsy, it is characterized by crescent formation. RPGN may be associated with the presence of circulating antibodies. We report a case of type IV RPGN [ANCA and Anti–glomerular basement membrane (anti-GBM) antibody disease], a severe disease causing a difficult to treat picture. Our case was complicated by severe thrombocytopenia due to the use of heparin and later on by thrombotic microangiopathy. These events occurred rapidly, making the clinical framing and management decisions very hard.
Highlights
Progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by features of glomerular disease in the urinalysis and by progressive loss of renal function in a short period
Implication for health policy/practice/research/medical education: We report a case with the contemporaneous presence of multiple auto-antibodies and a clinical feature of rapidly progressive glomerulonephritis
Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by features of glomerular disease in the urinalysis and by progressive loss of renal function in a short period
Summary
Progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by features of glomerular disease in the urinalysis and by progressive loss of renal function in a short period (weeks or a few months). Sometimes ANCA and anti–glomerular basement membrane (anti-GBM) antibody may be contemporaneously present, so-called type 4 RPGN [3] causing a severe clinical picture; hemoptysis, resistant hypertension, alterations of bleeding tests [4,5] and rapid impairment of renal function. We report a case of type IV RPGN [ANCA and anti–glomerular basement membrane (anti-GBM) antibody] [3] complicated by severe thrombocytopenia due to the use of heparin and later on by thrombotic microangiopathy (TMA). These events occurred in rapid succession, making the clinical framing and management decisions very hard. The patient was discharged after a few days, and she remained in chronic dialysis treatment and did not develop pulmonary symptoms
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