Atypical anti-glomerular basement membrane disease presenting as macroscopic haematuria, loin pain and acute kidney injury after intensive exercise

Arnaud Le Flecher; Nicolas Viallet; Delphine Hebmann; Bertrand Chauveau; Henri Vacher Coponat

doi:10.1093/ckj/sfz044

Atypical anti-glomerular basement membrane disease presenting as macroscopic haematuria, loin pain and acute kidney injury after intensive exercise

Clin Kidney J. 2019 Apr 23;12(6):801-802. doi: 10.1093/ckj/sfz044. eCollection 2019 Dec.

Authors

Arnaud Le Flecher¹, Nicolas Viallet¹, Delphine Hebmann¹, Bertrand Chauveau², Henri Vacher Coponat^{1

3}

Affiliations

¹ Department of Nephrology - Transplantation, CHU de la Réunion Felix Guyon, Saint Denis, Réunion, France.
² Department of Pathology, CHU Necker-Enfants Malades, Paris, France.
³ Université de la Réunion, UFR Santé, Réunion, France.

Abstract

We report a 35-year-old man who suffered from recurrent macroscopic haematuria after intensive exercise. One episode was associated with bilateral loin (flank) pain and severe acute kidney injury. His kidney biopsy revealed an atypical anti-glomerular basement membrane (GBM) disease typified by bright linear GBM staining for monotypic immunoglobulin G but without a diffuse crescentic phenotype and no circulating anti-GBM antibody. Outcome was spontaneously favourable. The patient had no recurrence or urine abnormality without running. The original presentation emphasized that exercise could reveal an underlying glomerulopathy.

Keywords: acute kidney injury; atypical anti-glomerular basement membrane disease; exercise; haematuria; loin pain.