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]
Summary
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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