Rivedal Mariell, Haaskjold Yngvar Lunde, Berge Hedda, Knoop Thomas
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Kidney Med. 2023 Aug 9;5(10):100709. doi: 10.1016/j.xkme.2023.100709. eCollection 2023 Oct.
Antiglomerular basement membrane (anti-GBM) disease is a rare, small-vessel vasculitis that affects the capillary beds of the kidneys and lungs. Although exceedingly rare, several case reports have described anti-GBM disease with a concurrent cancer diagnosis, suggesting a possible correlation between these 2 conditions. Herein, we describe the first known case to our knowledge of a woman in her early 60s with simultaneous anti-GBM disease and clear cell renal cell carcinoma, in which the tumor was thought to have been the substrate for anti-GBM disease. We believe that renal cell carcinoma may have contributed to the production of anti-GBM autoantibodies and, thus, anti-GBM disease. The concurrence of these 2 conditions complicated the treatment of the patient, who was hemodialysis-dependent at the time of hospital discharge. This report highlights the importance of considering anti-GBM disease as a potential diagnosis in patients with acute kidney failure, and how important it is to identify both clear cell renal cell carcinoma and anti-GBM disease at an early stage to improve outcomes.
抗肾小球基底膜(anti-GBM)病是一种罕见的小血管血管炎,可累及肾脏和肺部的毛细血管床。尽管极为罕见,但已有数例病例报告描述了抗GBM病与癌症诊断同时存在的情况,提示这两种疾病之间可能存在关联。在此,我们报告了据我们所知的首例60岁出头女性同时患有抗GBM病和透明细胞肾细胞癌的病例,其中肿瘤被认为是抗GBM病的发病基础。我们认为肾细胞癌可能促使了抗GBM自身抗体的产生,进而导致了抗GBM病。这两种疾病的并存使患者的治疗变得复杂,患者出院时依赖血液透析。本报告强调了在急性肾衰竭患者中考虑抗GBM病作为潜在诊断的重要性,以及早期识别透明细胞肾细胞癌和抗GBM病对改善预后的重要性。