Abstract

BackgroundAntineutrophil cytoplasmic antibodies (ANCA) and Anti-glomerular basement membrane (GBM) antibodies often induce rapidly progressive glomerulonephritis (RPGN). Some reports have demonstrated RPGN with the sequential appearance of ANCA then anti-GBM antibodies, suggesting that ANCA may induce the development of anti-GBM antibodies. Whereas, many reports have shown that the development of ANCA is associated with various infectious diseases, such as non-tuberculous mycobacterial infection.Case presentationA 65-year-old woman with pulmonary non-tuberculous mycobacterial (NTM) infection was monitored without treatment. One year later, serum myeloperoxidase (MPO)- ANCA were elevated (14.1 U/mL (normal value < 3.0 U/ml)). A high fever and RPGN appeared 1 year later, and serum MPO-ANCAs were 94.1 U/mL. Anti-GBM antibodies were also detected. A renal biopsy revealed crescentic glomerulonephritis with linear deposits of IgG and C3c along the GBM and interstitial inflammation with endarteritis of arterioles. The diagnosis was RPGN associated with anti-GBM nephritis and ANCA-associated vasculitis.ConclusionThis report shows that preceding NTM infection may have induced ANCA and anti-GBM antibodies and caused the development of RPGN.

Highlights

  • Antineutrophil cytoplasmic antibodies (ANCA) and Anti-glomerular basement membrane (GBM) antibodies often induce rapidly progressive glomerulonephritis (RPGN)

  • This report shows that preceding non-tuberculous mycobacterial (NTM) infection may have induced ANCA and anti-GBM antibodies and caused the development of RPGN

  • Some case reports have focused on the development of associated vasculitis (AAV) secondary to pulmonary nontuberculous mycobacterial (NTM) infections caused predominantly by M. avium or M. intracellulare [5, 6]

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Summary

Conclusion

This report shows that preceding NTM infection may have induced ANCA and anti-GBM antibodies and caused the development of RPGN. Keywords: Nontuberculous mycobacteriosis, Myeloperoxidase-antineutrophil cytoplasmic antibody, Anti-glomerular basement membrane antibody, Rapidly progressive glomerulonephritis

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