The uncertain significance of anti-glomerular basement membrane antibody among HIV-infected persons with kidney disease

Am J Kidney Dis. 2006 Oct;48(4):e55-9. doi: 10.1053/j.ajkd.2006.06.007.

Abstract

Glomerular lesions that complicate patients with human immunodeficiency virus (HIV) infection include HIV-associated nephropathy, membranous glomerulopathy, and immune-complex glomerulonephritides. This case series presents 3 patients with clinically significant renal disease and positive test results for anti-glomerular basement membrane (anti-GBM) antigen. Characteristic histological findings that would suggest anti-GBM antibodies have a significant role in the pathological state of each patient's kidney disease were absent. In addition, each patient recovered without specific treatment for anti-GBM disease. This case series suggests that anti-GBM antibodies likely are related to the B-cell expansion previously described in patients with HIV infection. We propose that clinicians interpret results of anti-GBM antibody tests carefully for patients with HIV infection, considering biopsy before empiric therapy, particularly in a clinical presentation that is atypical for Goodpasture disease.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • AIDS-Associated Nephropathy / etiology
  • AIDS-Associated Nephropathy / immunology*
  • AIDS-Associated Nephropathy / pathology
  • Adult
  • Anti-Glomerular Basement Membrane Disease / immunology
  • Anti-Glomerular Basement Membrane Disease / pathology
  • Antibodies / blood*
  • Antibodies / physiology
  • Autoantibodies
  • B-Lymphocytes / pathology
  • Disease Progression
  • Female
  • Humans
  • Kidney Glomerulus / pathology
  • Male

Substances

  • Antibodies
  • Autoantibodies
  • antiglomerular basement membrane antibody