Anti-glomerular basement membrane disease with IgA nephropathy: A case report

Table 1 Laboratory data

Variable	Reference range	Initial value on admission	Value after intervention for half a year
Routine blood examination
White cell count (× 109/L)	3.5−9.5	8.08	12.43
Red cell count (× 1012/L)	4.3−5.8	3.55	4.04
Hemoglobin (g/L)	130−175	108	126
Biochemical blood examination
Urea nitrogen (mmol/L)	2.9−8.2	6.04	8.85
Creatinine (μmol/L)	59−104	133	109
Glucose (mmol/L)	3.9−6.1	4.99	4.99
Sodium (mmol/L)	137−147	139.8	139
Potassium (mmol/L)	3.5−5.3	3.81	3.90
Chloride (mmol/L)	99−101	104.7	103.90
Calcium (mg/dL)	2.2−2.65	2.15	2.37
Phosphorus (mg/dL)	0.81−1.45	1.25	0.96
Albumin (g/L)	40−55	32.51	41.75
Immunological indexes
ANA		Negative	−
ASO (U/mL)	0−116	Less than 25	−
C3 (g/L)	0.79−1.52	1.15	−
C4 (g/L)	0.16−0.38	0.339	−
IgG (g/L )	7.51−15.6	9.87	−
IgA (g/L)	0.82−4.53	2.27	−
IgM (g/L)	0.46−3.04	0.685	−
Anti-PR3-ANCA (RU/mL)	0−20	0	−
Anti-MPO-ANCA (RU/mL)	0−20	0	−
Kappa light chain (mg/dL)		Negative	−
Lambda light chain (mg/dL)		Negative	−
Anti-PLA2R antibody (RU/mL)		Less than 5	−
Anti-THSD7A antibody		Negative	−
Anti-GBM antibody (RU/mL)	0−20	68	−
Urinalysis
Occult blood		3+	2+
RBCs (per high-power field)	0−3	45.09	10.6
Protein		2+	2+
24 h urinary total protein (g/24 h)		5.16	1.68

RBCs: Red blood cells; ANA: Antinuclear antibodies; ASO: Arteriosclerosis obliterans.

Table 2 Characteristics of some cases of coexistence of anti-glomerular basement membrane disease and IgA nephropathy in recent 5 years

Ref.	Sex (Male/Female)	Age (yr)	Initial serum creatinine (μmol/L)	Pulmonary hemorrhage	Gross hematuria	Anti-GBM antibody	Crescent ratio	Treatment methods	Treatment outcome
Annamalai et al[14], 2021	Female	22	168.53 increase to 282.88 in one week	Negative	Positive	96 U/mL	7/10	IV Methyl-PD + oral-PD	Improved, nondialysis-dependent renal dysfunction
Suh et al[15], 2019	Female	38	57.46 increase to 481.78 in three months	Negative	Positive	187.2 U/mL	11/16	IV Methyl-PD + oral-PD + IV cyclophsphamide	Improved, nondialysis-dependent renal dysfunction
Kojima et al[13], 2019	Female	66	91.62 increase to 400.45 in one month	Negative	Negative	116 IU/mL	18/25	HD + PE + IV Methyl-PD + oral-PD	HD
Xu et al[16], 2016	Female	50	157 increase to 220 in ten days	Negative	Positive	258.3 EU/mL	16/18	IV Methyl-PD + Oral-PD + Mycophenolate mofetil	Improved, nondialysis-dependent renal dysfunction
This case	Male	49	133 without rapid progress	Negative	Negative	68 RU/mL	21/29	IV Methyl-PD + oral-PD + IV cyclophsphamide	Improved, nondialysis-dependent renal dysfunction

GBM: Glomerular basement membrane; IV: Intravenous injection; Methyl-PD: Methylprednisolone; oral-PD: oral prednisolone; PE: Plasma exchange; HD: Hemodialysis.