Abstract:
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.
摘要:
抗肾小球基底膜(抗GBM)疾病是一种罕见的,影响肾脏和肺毛细血管床的小血管炎。虽然非常罕见,一些病例报告描述了抗GBM疾病并发癌症诊断,表明这两个条件之间可能存在相关性。在这里,我们描述了我们所知的第一个已知病例,一名60多岁的女性同时患有抗GBM疾病和透明细胞肾细胞癌,其中肿瘤被认为是抗GBM疾病的底物。我们认为肾细胞癌可能有助于抗GBM自身抗体的产生,因此,抗GBM病。这两种情况的并发使患者的治疗复杂化,出院时依赖血液透析的患者。该报告强调了将抗GBM疾病作为急性肾衰竭患者的潜在诊断的重要性。以及在早期阶段识别透明细胞肾细胞癌和抗GBM疾病以改善预后的重要性。