Chittka D, Lennartz L, Jung B, Banas B, Bergler T
Abteilung Nephrologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
Internist (Berl). 2020 Apr;61(4):416-423. doi: 10.1007/s00108-020-00773-5.
This article presents a case of recurrent anti-GBM disease (with antibodies against the glomerular basement membrane [GBM]) in a 17-year-old patient successfully treated with rituximab. Kidney biopsy with detection of linear deposition of immunoglobulin G (IgG) along the basement membrane is the diagnostic gold standard, which should be accompanied by serological testing. However, standard assays for the detection of anti-GBM antibodies have a high rate of false-negative results. In this particular case, an increase in proteinuria despite standard therapy (plasmapheresis, steroids, cyclophosphamide) was the clinical correlate of relapsing disease. The use of rituximab completely resolved the recurrent anti-GBM disease.
本文介绍了一例17岁复发性抗肾小球基底膜病（抗肾小球基底膜[GBM]抗体阳性）患者，使用利妥昔单抗成功治疗的病例。肾活检检测到免疫球蛋白G（IgG）沿基底膜呈线性沉积是诊断的金标准，同时应进行血清学检测。然而，检测抗GBM抗体的标准检测方法假阴性率很高。在这个特殊病例中，尽管采用了标准治疗（血浆置换、类固醇、环磷酰胺），蛋白尿仍增加，这是疾病复发的临床相关表现。使用利妥昔单抗完全解决了复发性抗GBM病。
