Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review
Abstract Background Rapidly progressive glomerulonephritis (RPGN) is clinically manifestations as a rapidly progressive renal failure and pathologically as crescentic and necrotizing lesions with infiltration of inflammatory cells in the glomeruli. Uremic encephalopathy (UE) usually develops in pati...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Immunity, Inflammation and Disease |
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| Online Access: | https://doi.org/10.1002/iid3.1074 |
| _version_ | 1797404147986726912 |
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| author | Chongyang Han Xiangrong Cui Zhicheng Tan Yafeng Li Yufeng Qiao |
| author_facet | Chongyang Han Xiangrong Cui Zhicheng Tan Yafeng Li Yufeng Qiao |
| author_sort | Chongyang Han |
| collection | DOAJ |
| description | Abstract Background Rapidly progressive glomerulonephritis (RPGN) is clinically manifestations as a rapidly progressive renal failure and pathologically as crescentic and necrotizing lesions with infiltration of inflammatory cells in the glomeruli. Uremic encephalopathy (UE) usually develops in patients who are suffering from acute or chronic renal failure. Objective The purpose of this article is to provide reference for clinical diagnosis and treatment of renal disease complicated with seizures. Patients Two cases of anti‐glomerular basement membrane type rapidly progressive glomerulonephritis complicated with seizures were reported. Materials & Methods In case 1, a 40‐year‐old woman was hospitalized for the treatment of nausea, anorexia, and fever. On admission, she presented with elevated serum inflammatory indicators, moderate anemia, and advanced acute kidney injury requiring hemodialysis. Her anti‐glomerular basement membrane (GBM) antibody in serum and renal tissues was found to be extremely high. She was finally diagnosed with anti‐GBM disease. She was treated with a combination of corticosteroid pulse therapy, oral cyclophosphamide and prednisolone, and plasma exchange, while continued to require maintenance hemodialysis for end‐stage kidney disease. During treatment, she suddenly suffered blindness, seizure, and consciousness disturbance. She was diagnosed as posterior reversible leukoencephalopathy syndrome by magnetic resonance imaging (MRI). The posterior reversible leukoencephalopathy syndrome subsided quickly after control of her hypertension and reinforcement of immunosuppressive treatment. In case 2, the patient also developed epileptic symptoms on the basis of GBM disease, and was given treatment similar to that of Case 1, so that the epileptic symptoms were controlled. Result Reversible posterior leukoencephalopathy syndrome, especially when accompanied by cerebral hemorrhage, may lead to irreversible and lethal neurological abnormalities, and nephrologists should, therefore, be aware of the potential risk of reversible posterior leukoencephalopathy syndrome in patients with anti‐GBM disease. We can discuss the current two cases in the light of the previous literature. |
| first_indexed | 2024-03-09T02:50:44Z |
| format | Article |
| id | doaj.art-eb72e53e7f9a49d3bee67541a1689ecb |
| institution | Directory Open Access Journal |
| issn | 2050-4527 |
| language | English |
| last_indexed | 2024-03-09T02:50:44Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Immunity, Inflammation and Disease |
| spelling | doaj.art-eb72e53e7f9a49d3bee67541a1689ecb2023-12-05T11:18:03ZengWileyImmunity, Inflammation and Disease2050-45272023-11-011111n/an/a10.1002/iid3.1074Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature reviewChongyang Han0Xiangrong Cui1Zhicheng Tan2Yafeng Li3Yufeng Qiao4Department of Nephrology Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University Taiyuan ChinaReproductive Medicine Center, The Affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of Shanxi Shanxi Maternal and Child Health Hospital Taiyuan ChinaDepartment of Nephrology Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University Taiyuan ChinaDepartment of Nephrology Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University Taiyuan ChinaDepartment of Nephrology Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University Taiyuan ChinaAbstract Background Rapidly progressive glomerulonephritis (RPGN) is clinically manifestations as a rapidly progressive renal failure and pathologically as crescentic and necrotizing lesions with infiltration of inflammatory cells in the glomeruli. Uremic encephalopathy (UE) usually develops in patients who are suffering from acute or chronic renal failure. Objective The purpose of this article is to provide reference for clinical diagnosis and treatment of renal disease complicated with seizures. Patients Two cases of anti‐glomerular basement membrane type rapidly progressive glomerulonephritis complicated with seizures were reported. Materials & Methods In case 1, a 40‐year‐old woman was hospitalized for the treatment of nausea, anorexia, and fever. On admission, she presented with elevated serum inflammatory indicators, moderate anemia, and advanced acute kidney injury requiring hemodialysis. Her anti‐glomerular basement membrane (GBM) antibody in serum and renal tissues was found to be extremely high. She was finally diagnosed with anti‐GBM disease. She was treated with a combination of corticosteroid pulse therapy, oral cyclophosphamide and prednisolone, and plasma exchange, while continued to require maintenance hemodialysis for end‐stage kidney disease. During treatment, she suddenly suffered blindness, seizure, and consciousness disturbance. She was diagnosed as posterior reversible leukoencephalopathy syndrome by magnetic resonance imaging (MRI). The posterior reversible leukoencephalopathy syndrome subsided quickly after control of her hypertension and reinforcement of immunosuppressive treatment. In case 2, the patient also developed epileptic symptoms on the basis of GBM disease, and was given treatment similar to that of Case 1, so that the epileptic symptoms were controlled. Result Reversible posterior leukoencephalopathy syndrome, especially when accompanied by cerebral hemorrhage, may lead to irreversible and lethal neurological abnormalities, and nephrologists should, therefore, be aware of the potential risk of reversible posterior leukoencephalopathy syndrome in patients with anti‐GBM disease. We can discuss the current two cases in the light of the previous literature.https://doi.org/10.1002/iid3.1074antiglomerular basement membrane diseaseepilepsyreversible posterior leukoencephalopathy syndromeseizureuremic encephalopathy |
| spellingShingle | Chongyang Han Xiangrong Cui Zhicheng Tan Yafeng Li Yufeng Qiao Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review Immunity, Inflammation and Disease antiglomerular basement membrane disease epilepsy reversible posterior leukoencephalopathy syndrome seizure uremic encephalopathy |
| title | Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review |
| title_full | Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review |
| title_fullStr | Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review |
| title_full_unstemmed | Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review |
| title_short | Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review |
| title_sort | antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures two cases and literature review |
| topic | antiglomerular basement membrane disease epilepsy reversible posterior leukoencephalopathy syndrome seizure uremic encephalopathy |
| url | https://doi.org/10.1002/iid3.1074 |
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