Anti-glomerular Basement Membrane Glomerulonephritis During the First Trimester of Pregnancy

• Published in: Internal Medicine 2021/03/01, Vol.60(5), pp.765-770
• Main Authors: Kai, Hirayasu, Usui, Joichi, Tawara, Takashi, Takahashi-Kobayashi, Mayumi, Ishii, Ryota, Tsunoda, Ryoya, Fujita, Akiko, Nagai, Kei, Kaneko, Shuzo, Morito, Naoki, Saito, Chie, Hamada, Hiromi, Yamagata, Kunihiro
• Format: Article
• Language: English
• Subjects: 1st trimester of pregnancy; Adult; anti-glomerular basement membrane glomerulonephritis (anti-GBM GN); Antibodies, Antineutrophil Cytoplasmic; Antineutrophil cytoplasmic antibodies; Autoantibodies; Basement membranes; Case Report; Creatinine; Drb1 protein; Female; Fetuses; Glomerulonephritis; Glomerulonephritis - diagnosis; Hemodialysis; Histocompatibility antigen HLA; HLA-DRB11502:01; Humans; Internal medicine; Kidney Glomerulus; Leukocytes (neutrophilic); Peroxidase; plasma exchange (PE); Prednisolone; Pregnancy; Pregnancy Trimester, First; rapid progressive glomerulonephritis (RPGN)
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.5722-20

A 28-year-old woman was admitted during the eighth week of her pregnancy because her clinical course was consistent with rapid progressive glomerulonephritis (RPGN). Anti-glomerular basement membrane antibody (anti-GBM Ab) and myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) were positive, and the anti-GBM Ab titer being extremely high. She was treated with hemodialysis, plasma exchange and prednisolone. She survived the illness; however, neither the fetus nor her kidney function could be rescued. She had human leukocyte antigen (HLA)-DRB1*1502:01, which differs from the DRB1*1501 associated with anti-GBM GN. When patients have particular symptoms, we should check the urine and serum creatinine to exclude RPGN, even in cases of pregnancy.