Pediatric anti-GBM crescentic glomerulonephritis: partial renal recovery following plasmapheresis and mycophenolate mofetil.
Quynh Trang Nguyen, Thu Huong Nguyen, Thien Nam Thai et al.
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Case in brief
A 14-year-old girl presented with acute edema and hypertension. Investigations showed hematuria, proteinuria, hypoalbuminemia, worsening renal function, and positive anti-GBM antibodies. Kidney biopsy demonstrated diffuse crescentic glomerulonephritis with linear IgG along the glomerular basement membrane, confirming anti-GBM disease. She received high-dose corticosteroids, plasmapheresis, and mycophenolate mofetil. After three months, clinical and laboratory findings had improved, with partial recovery of renal function.
What made this case unusual
The case describes pediatric anti-GBM disease treated with a mycophenolate-containing regimen rather than a cyclophosphamide-based regimen, with partial renal recovery.
Diagnostic / clinical pearl
In a child with rapidly worsening renal function, hematuria, and proteinuria, anti-GBM antibodies and biopsy findings of crescents with linear glomerular basement membrane IgG can establish the diagnosis.
Why it matters
The reported improvement suggests that a regimen including mycophenolate mofetil may be feasible in selected patients, although this single case does not establish comparative efficacy.