A Case of Anti-Glomerular Basement Membrane Disease with Renal and Ocular Involvement Treated with Anti-VEGF Injections

Context: Anti-Glomerular Basement Membrane (GBM) disease is a rare disease, with limited population data. It is estimated to affect 0.5-2 cases per million of the population and makes up 1-5% of patients with glomerulonephritis. Patients classically present with renal and/or pulmonary involvement, however additional manifestation have rarely been reported.

Case Report: A 45yr old female presented with fever, haematuria and acute renal failure necessitating haemodialysis. She was diagnosed with anti-glomerular basement membrane disease (anti-GBM, Goodpasture’s) on the basis of elevated antibody titres and renal biopsy demonstrating a rapidly progressive crescentic glomerulonephritis with positive immunofluorescence. During the course of her management she developed blurred vision in the left eye, which was found to be due to choroidal neo-revascularisation.

Conclusion: The alpha 3 subunit of type IV, the target of the anti-GBM antibody, is primarily found within the kidney and lung however can also be isolated in other sites including the eye. Here we describe a case of anti-GBM disease affecting the kidney and eye. Our patient was successfully treated with anti-VEGF injections, the first time this has been described for this indication.

Author(s): Daniela Potter, Gerald Liew and Bruce Cleland

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