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Caught in the Crossfire- A Case of Anti GBM Disease with Rapid Renal Decline

Ishana Gaur

Background: Anti-Glomerular Basement Membrane (Anti-GBM) disease is a rare autoimmune disorder that primarily affects the kidneys and less commonly, the lungs. The rapid progression of glomerulonephritis is an important feature of this disease, leading to significant renal damage if not treated promptly. Early diagnosis and treatment are essential to preventing irreversible kidney injury.

Case Description: We report a case of a 45-year-old male who presented with 15 days of hematuria and 2 days of breathlessness. The patient had no history of hypertension or diabetes. Clinical examination revealed pallor, high blood pressure and fine crepitations in bilateral lower lung fields. Laboratory investigations showed elevated serum creatinine, reduced hemoglobin and significant proteinuria. Anti-GBM antibodies were markedly elevated and a kidney biopsy confirmed the diagnosis of crescentic glomerulonephritis with a necrotizing pattern. The patient was treated with plasmapheresis, steroids and cyclophosphamide, along with maintenance hemodialysis. Despite the aggressive nature of the disease, early intervention helped stabilize his renal function.

Conclusion: This case highlights the importance of rapid diagnosis and prompt initiation of aggressive treatment in patients with anti-GBM disease presenting as rapidly progressive glomerulonephritis. Early intervention is a key to preserving renal function and improving patient outcomes.