We present the case of a woman with atypical anti-glomerular basement membrane (anti-GBM) nephritis associated with concurrent pulmonary infection with Mycobacterium avium. A kidney biopsy showed crescentic glomerulonephritis with 50% active crescents and linear IgG staining, but no circulating anti-GBM antibodies were detected, and the patient did not have pulmonary hemorrhage. Despite treatment with a triple-regimen of antibiotics, corticosteroids, and plasmapheresis, the patient did not regain kidney function. One year later she is on maintenance dialysis and has still not cleared the infection with M. avium.
Keywords: acute kidney injury; atypical anti-glomerular basement membrane disease; crescentic glomerulonephritis; non-tuberculous-mycobacteria; rapidly progressive glomerular nephritis.
© Dustri-Verlag Dr. K. Feistle.