Anti-glomerular basement membrane antibody-mediated glomerulonephritis combined with non-fulminant acute viral hepatitis A

Abstract

Anti-glomerular basement membrane antibody-mediated glomerulonephritis (anti-GBM Ab-mediated GN) is a rare autoimmune disease, characterized by crescentic glomeruli and linear GBM staining with immunoglobulin G (IgG). Exposure to viruses can trigger the formation of autoantibodies to the GBM. We report the first case of anti-GBM Ab-mediated GN associated with hepatitis A virus (HAV) infection. Although the pathogenesis of HAV-related anti-GBM Ab-mediated GN has not been documented, we suggest that the immune complexes produced by HAV infection might be deposited in the glomerular capillary walls and lead to immune complex-mediated glomerular damage, resulting in exposure of the sequestered GBM antigens and the formation of anti-GBM antibodies. Under immunosuppressive and intravenous cyclophosphamide therapy, his renal function has been improving without development of pulmonary symptoms.