Sequential development of anti-GBM nephritis and ANCA-associated pauci-immune glomerulonephritis

Verburgh, Cornelis A.; Bruijn, Jan A.; Daha, Mohamed R.; Es, Leendert A. van

doi:10.1016/s0272-6386(99)70366-5

Cited by 35 publications

(26 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There have been multiple case reports of elevated ANCA levels months to years before the development of anti-GBM disease. [11][12][13][14] In addition, previous literature demonstrates that elevated ANCA levels are associated with anti-GBM disease. 5,15 A single center study of 205 patients with anti-GBM disease reported 30.7% with elevated ANCA levels.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic Autoantibodies Associate with Future Anti-glomerular Basement Membrane Disease

Olson

Arbogast

Baker

et al. 2011

Journal of the American Society of Nephrology

112

View full text Add to dashboard Cite

The pathophysiology of anti-glomerular basement membrane (anti-GBM) disease before clinical presentation is unknown. The presence of anti-GBM, anti-proteinase 3 (PR3), and anti-myeloperoxidase (MPO) antibodies associate with the disease at the time of diagnosis, but little is known about the presence of these autoantibodies before diagnosis. We used serum samples from the Department of Defense Serum Repository to conduct a case-control study involving 30 patients diagnosed with anti-GBM disease and 30 healthy controls matched for the age, gender, race, and age of the serum samples. We analyzed a maximum of three samples from each subject: the most recent sample before diagnosis, the penultimate sample before diagnosis, and the oldest sample available; the average time between the most recent sample and diagnosis was 195 days (range, 4 to 1346 days). Elevated anti-GBM levels (Ն3 U/ml) were present in four patients, all less than 1 year before diagnosis but in no controls. Detectable anti-GBM antibody levels (Ն1 U/ml but Ͻ3 U/ml) in a single serum sample before diagnosis were more frequent in cases than controls (70% versus 17%, P Ͻ 0.001). Only study patients had detectable anti-GBM levels in multiple samples before diagnosis (50% versus 0%, P Ͻ 0.001). Almost all patients had detectable anti-PR3 and/or anti-MPO that preceded the onset of disease. Among patients with a clear antecedent antibody, anti-PR3 or anti-MPO always became detectable before the anti-GBM antibody. In summary, our data describe the subclinical formation of autoantibodies, which improves our understanding of the pathophysiology of anti-GBM disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Asymptomatic Autoantibodies Associate with Future Anti-glomerular Basement Membrane Disease

Olson

Arbogast

Baker

et al. 2011

Journal of the American Society of Nephrology

112

View full text Add to dashboard Cite

show abstract

“…The finding of the similar age distribution between ‘double positive’ patients and patients with AASV just provided some support for this hypothesis. Some reports indicated that patients were detected to have positive anti-GBM antibodies in serum a few months after the detection of ANCA [17, 18], which provided further evidence. Some studies also showed that ANCA could be directly pathogenic to GBM [19].…”

Section: Discussionmentioning

confidence: 89%

Characteristics and Outcome of Chinese Patients with Both Antineutrophil Cytoplasmic Antibody and Antiglomerular Basement Membrane Antibodies

et al. 2007

View full text Add to dashboard Cite

Background: Antineutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis (AASV) is a systemic autoimmune disease. A number of cases have been found to have antiglomerular basement membrane (GBM) antibody-positive serum. The purpose of the current article is to investigate the prevalence of anti-GBM antibodies in sera from a large cohort of Chinese patients with AASV and to characterize the clinical and pathological features of the ‘double positive’ patients. Methods: Sera from 652 patients with AASV were screened by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot analysis using purified human α(IV)NC1 as antigen. Antigen specificity of anti-GBM antibodies was determined by ELISA using recombinant human α3(IV)NC1 as solid phase ligand. Clinical and pathological data of patients with both ANCA and anti-GBM antibodies were analyzed retrospectively. Results: 61/652 (9.36%) sera from patients with AASV were serum anti-GBM antibody positive and all recognized recombinant human α3(IV)NC1. All the cases had renal involvement, 37/48 (77.1%) cases had pulmonary involvement, non-specific symptoms and other multisystem involvements were common. The renal survival was 14.6% (7/48) and patient survival was 37.5% (18/48) respectively at the end of 1 year. The following factors predicted poor prognosis: (1) serum creatinine >700 µmol/l (p = 0.034); (2) oliguria or anuria on diagnosis (p = 0.001); (3) high percentage (>85%) of glomeruli with crescents (p = 0.011); (4) high titer anti-GBM antibodies (p = 0.003), and (5) hemoptysis (p = 0.049). Conclusion: Patients with double antibodies were not rare in AASV. They had multisystem involvement but poor short-term prognosis.Anti-GBM antibodies should be detected on diagnosis of AASV, especially for old ages.

show abstract

“…First, susceptible age of ''double positive'' disease is greater than ''pure'' anti-GBM disease, resembling ANCA-associated vasculitis [5][6][7][8][9]. This feature is proposed as sequential sensitization of GBM antigen following glomerular basement membrane destruction via ANCA-associated vasculitis, and the hypothesis is supported by cases showing positive conversion of anti-GBM antibody following ANCA-associated vasculitis [5,8,[20][21][22]. Second, ''double positive'' disease has a higher risk of relapse than ''pure'' anti-GBM disease [1,8,11].…”

Section: Discussionmentioning

confidence: 99%

A case of PR3–ANCA-positive anti-GBM disease associated with intrarenal arteritis and thrombotic microangiopathy

et al. 2016

View full text Add to dashboard Cite

Sequential development of anti-GBM nephritis and ANCA-associated pauci-immune glomerulonephritis

Cited by 35 publications

References 17 publications

Asymptomatic Autoantibodies Associate with Future Anti-glomerular Basement Membrane Disease

Asymptomatic Autoantibodies Associate with Future Anti-glomerular Basement Membrane Disease

Characteristics and Outcome of Chinese Patients with Both Antineutrophil Cytoplasmic Antibody and Antiglomerular Basement Membrane Antibodies

A case of PR3–ANCA-positive anti-GBM disease associated with intrarenal arteritis and thrombotic microangiopathy

Contact Info

Product

Resources

About