Anti-GBM disease in pregnancy

We present the case of a pregnant woman in her 20s who presented in her second trimester with severe pulmonary haemorrhage and dialysis-dependent acute kidney failure due to antiglomerular basement membrane (GBM) disease. Responding to therapy, she recovered kidney function and delivered a baby. Dur...

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Bibliographic Details
Published in:	BMJ case reports Vol. 17; no. 4
Main Authors:	Kafagi, Abdul Hadi, Li, Anna S, Jayne, David, Brix, Silke R
Format:	Journal Article
Language:	English
Published:	England 30-04-2024
Subjects:	Acute Kidney Injury - etiology Adult Anti-Glomerular Basement Membrane Disease - complications Anti-Glomerular Basement Membrane Disease - diagnosis Anti-Glomerular Basement Membrane Disease - therapy Cyclophosphamide - therapeutic use Female Humans Immunosuppressive Agents - therapeutic use Plasma Exchange - methods Pregnancy Pregnancy Complications - drug therapy Rituximab - therapeutic use Dialysis Vasculitis Obstetrics, gynaecology and fertility Renal medicine
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Summary:	We present the case of a pregnant woman in her 20s who presented in her second trimester with severe pulmonary haemorrhage and dialysis-dependent acute kidney failure due to antiglomerular basement membrane (GBM) disease. Responding to therapy, she recovered kidney function and delivered a baby. During her pregnancy, she developed cytomegalovirus viraemia, gestational diabetes and pre-eclampsia. Here, we report the first combined use of cyclophosphamide, rituximab and intensified plasma exchange in anti-GBM disease in pregnancy, allowing minimal exposure to cytotoxic medication, resulting in live birth and dialysis independence.
ISSN:	1757-790X
DOI:	10.1136/bcr-2023-257767