Aug 3, 2019

Recurrent anti-GBM disease with T-cell large granular lymphocytic leukemia: A case report

Medicine
Min ZhangJun Xue

Abstract

Anti-glomerular basement membrane disease (anti-GBM disease) is a rare small vessel vasculitis caused by autoantibodies directed against the glomerular and alveolar basement membranes. Anti-GBM disease is usually a monophasic illness and relapse is rare after effective treatment. This article reports a case of coexistence of recurrent anti-GBM disease and T-cell large granular lymphocytic (T-LGL) leukemia. A 37-year-old man presented with hematuria, edema, and acute kidney injury for 2 months. Anti-GBM disease was diagnosed by renal biopsy, in which crescentic glomerulonephritis was observed with light microscopy, strong linear immunofluorescent staining for immunoglobulin G on the GBM and positive serum anti-GBM antibody. Given this diagnosis, the patient was treated with plasmapheresis, steroids, and cyclophosphamide for 4 months. The anti-GBM antibody titer was maintained to negative level but the patient remained dialysis-dependent. One year later, the patient suffered with a relapse of anti-GBM disease, after an extensive examination, he was further diagnosed T-LGL leukemia by accident. The patient received cyclosporine A therapy for T-LGL leukemia. After treatment with cyclosporine A, serum anti-GBM antibody became undete...Continue Reading

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Mentioned in this Paper

Guanosine
Autoantibodies
T-Lymphocyte
Cyclophosphamide
Hematologic Neoplasms
Follow-up
Peripheral Blood
Physicians; Physician/Osteopath; Pathology, Clinical
Bone Marrow
Cyclosporine

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