Anti-glomerular Basement Membrane Glomerulonephritis During the First Trimester of Pregnancy

Intern Med. 2021 Mar 1;60(5):765-770. doi: 10.2169/internalmedicine.5722-20. Epub 2020 Sep 30.

Abstract

A 28-year-old woman was admitted during the eighth week of her pregnancy because her clinical course was consistent with rapid progressive glomerulonephritis (RPGN). Anti-glomerular basement membrane antibody (anti-GBM Ab) and myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) were positive, and the anti-GBM Ab titer being extremely high. She was treated with hemodialysis, plasma exchange and prednisolone. She survived the illness; however, neither the fetus nor her kidney function could be rescued. She had human leukocyte antigen (HLA)-DRB1*1502:01, which differs from the DRB1*1501 associated with anti-GBM GN. When patients have particular symptoms, we should check the urine and serum creatinine to exclude RPGN, even in cases of pregnancy.

Keywords: 1st trimester of pregnancy; HLA-DRB1*1502:01; anti-glomerular basement membrane glomerulonephritis (anti-GBM GN); plasma exchange (PE); rapid progressive glomerulonephritis (RPGN).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Antineutrophil Cytoplasmic
  • Autoantibodies
  • Female
  • Glomerulonephritis* / diagnosis
  • Humans
  • Kidney Glomerulus
  • Peroxidase*
  • Pregnancy
  • Pregnancy Trimester, First

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Autoantibodies
  • Peroxidase