An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy
Introduction. The most commonly seen glomerular disease in HIV infected patients is HIV-associated nephropathy (HIVAN); however, a multitude of other nephropathies can occur in HIV infection with an almost equal cumulative frequency. We report an unusual case of a patient with clinical and histologi...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2014/956475 |
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| author | Vinay Minocha Raafat Makary Andreea Poenariu |
| author_facet | Vinay Minocha Raafat Makary Andreea Poenariu |
| author_sort | Vinay Minocha |
| collection | DOAJ |
| description | Introduction. The most commonly seen glomerular disease in HIV infected patients is HIV-associated nephropathy (HIVAN); however, a multitude of other nephropathies can occur in HIV infection with an almost equal cumulative frequency. We report an unusual case of a patient with clinical and histological evidence of HIVAN in which the diagnosis was initially confounded by the finding of an elevated serum anti-glomerular basement membrane (anti-GBM) antibody. Case Presentation. We present a case of a 27-year-old African American female with a history of schizophrenia, cocaine abuse, and HIV infection who upon admission to our hospital was found to have severe acute kidney injury requiring hemodialysis. Urine studies revealed nephrotic range proteinuria and a serological workup was positive for anti-GBM antibody elevation with a value of 91 units (normal: 0–20 units). A renal biopsy revealed HIVAN with no evidence of crescentic glomerulonephritis or anti-GBM disease. Conclusion. This case highlights the need for careful interpretation of anti-GBM antibody tests in HIV infected patients with kidney disease and, in particular, the need for biopsy confirmation of the diagnosis prior to starting therapy. More research is needed to study the prognostic correlation between the degree of anti-GBM antibody elevation in HIVAN and disease severity. |
| format | Article |
| id | doaj-art-68bdc3d9ae8e4a1d9fbc59883d7f710b |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-68bdc3d9ae8e4a1d9fbc59883d7f710b2025-02-03T06:07:45ZengWileyCase Reports in Nephrology2090-66412090-665X2014-01-01201410.1155/2014/956475956475An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated NephropathyVinay Minocha0Raafat Makary1Andreea Poenariu2Department of Internal Medicine, Division of Nephrology, University of Florida College of Medicine-Jacksonville, 4th Floor, LRC 653-1 West 8th Street, No. L18, Jacksonville, FL 32209, USADepartment of Pathology, University of Florida College of Medicine-Jacksonville, 4th Floor, LRC 653-1 West 8th Street, No. L18, Jacksonville, FL 32209, USADepartment of Internal Medicine, Division of Nephrology, University of Florida College of Medicine-Jacksonville, 4th Floor, LRC 653-1 West 8th Street, No. L18, Jacksonville, FL 32209, USAIntroduction. The most commonly seen glomerular disease in HIV infected patients is HIV-associated nephropathy (HIVAN); however, a multitude of other nephropathies can occur in HIV infection with an almost equal cumulative frequency. We report an unusual case of a patient with clinical and histological evidence of HIVAN in which the diagnosis was initially confounded by the finding of an elevated serum anti-glomerular basement membrane (anti-GBM) antibody. Case Presentation. We present a case of a 27-year-old African American female with a history of schizophrenia, cocaine abuse, and HIV infection who upon admission to our hospital was found to have severe acute kidney injury requiring hemodialysis. Urine studies revealed nephrotic range proteinuria and a serological workup was positive for anti-GBM antibody elevation with a value of 91 units (normal: 0–20 units). A renal biopsy revealed HIVAN with no evidence of crescentic glomerulonephritis or anti-GBM disease. Conclusion. This case highlights the need for careful interpretation of anti-GBM antibody tests in HIV infected patients with kidney disease and, in particular, the need for biopsy confirmation of the diagnosis prior to starting therapy. More research is needed to study the prognostic correlation between the degree of anti-GBM antibody elevation in HIVAN and disease severity.http://dx.doi.org/10.1155/2014/956475 |
| spellingShingle | Vinay Minocha Raafat Makary Andreea Poenariu An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy Case Reports in Nephrology |
| title | An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy |
| title_full | An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy |
| title_fullStr | An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy |
| title_full_unstemmed | An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy |
| title_short | An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy |
| title_sort | unusual case of anti gbm antibody elevation in hiv associated nephropathy |
| url | http://dx.doi.org/10.1155/2014/956475 |
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