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Portuguese Journal of Nephrology & Hypertension

Print version ISSN 0872-0169


NAQVI, Rubina  and  MUBARAK, Muhammed. Dual positive serology in a case of rapidly progressive glomerulonephritis in a middle aged woman. Port J Nephrol Hypert [online]. 2014, vol.28, n.2, pp.149-153. ISSN 0872-0169.

Dual positive cases of anti-glomerular basement membrane (GBM) antibody and anti-neutrophil cytoplasmic antibody (ANCA) associated nephritis are not rare in clinical nephrology practice. These patients often present with a clinical picture of rapidly progressive GN (RPGN). Published studies indicate that up to 30% of   patients with anti-GBM antibody nephritis have associated ANCA antibodies in their sera. On the other hand, only up to 5% of ANCA-associated GN patients have anti-GBM antibodies. There are conflicting reports in the literature on the significance of double positive antibodies on the presentation, clinical course and outcome of these patients. It is possible that the predominant behaviour depends on the predominance or time of appearance of either antibody. However, all studies conclude that the recovery of renal functions is rare with dual positivity of the above antibodies. We herein present a case of a middle-aged lady presenting with non-specific features of renal failure and was diagnosed to have crescentic GN on renal biopsy and both anti-GBM and ANCA antibodies in the serum. We discuss the management of this case in the light of existing literature on this subject

Keywords : Anti-GBM antibody; ANCA; Crescentic glomerulonephritis; rapidly progressive glomerulonephritis; serology; renal failure.

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