%0 Journal Article
%T Monotypic IgG1-kappa Atypical Anti-Glomerular Basement Membrane Nephritis: A Case Report
%A Danielle Lee
%A Harold Watson
%A Mario Madruga
%A Maxim Olivier
%A Steven Carlan
%A Viresh Mohanlal
%J Archive of "Case Reports in Nephrology and Dialysis".
%D 2019
%R 10.1159/000498844
%X Anti-glomerular basement membrane (anti-GBM) glomerulonephritis is a rare disease caused by autoantibodies against the glomerular basement membrane. Atypical anti-GBM nephritis is clinically less aggressive and characterized by the absence of circulating autoantibodies to the basement membrane. A previously healthy 53-year-old white woman presented with a rising creatinine over a short observation period. Renal biopsy, urinary sediment, and laboratory testing confirmed the diagnosis of atypical anti-GBM disease. She received plasmapheresis, steroids, and cyclophosphamide. She developed hemorrhagic cystitis early in the treatment from oral cyclophosphamide and mycophenolate mofetil was substituted as a first-line drug. She responded favorably and continued on mycophenolate mofetil without evidence of relapse. Despite the absence of circulating autoantibodies, a diagnosis of atypical anti-GBM nephritis should not be excluded if a high index of clinical suspicion exists. Early renal biopsy should be considered. Mycophenolate mofetil may be a reasonable replacement for oral cyclophosphamide in the treatment of atypical anti-GBM disease when cyclophosphamide is contraindicated
%K Renal failure
%K Atypical anti-glomerular basement membrane
%K Nephritis
%K Mycophenolate mofetil
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465719/