Successful treatment of anti-glomerular basement membrane antibody disease combined with membranous nephropathy using rituximab: a case report
- 1Wenzhou Central Hospital, Affiliated to Wenzhou Medical University
Abstract
Anti‑glomerular basement membrane (anti‑GBM) disease is a rare autoimmune disorder that classically manifests as rapidly progressive glomerulonephritis and pulmonary hemorrhage. The coexistence of anti-GBM disease and membranous nephropathy (MN) was first reported in 1976. Although such cases are rare, many reported patients develop progressive kidney injury and poor renal outcomes. We report a young man with sequential-onset dual glomerulopathy. He initially presented with MN alone and achieved partial remission following glucocorticoid and cyclosporine therapy. Three years later, he developed rapidly progressive glomerulonephritis, and kidney biopsy confirmed anti-GBM disease superimposed on pre-existing MN. This sequential pattern differs from the simultaneous onset of both lesions reported in many previous cases. To minimize gonadal toxicity, he received individualized therapy consisting of glucocorticoids, dose-adjusted cyclophosphamide, rituximab, and plasma exchange. He ultimately recovered normal kidney function and had a favorable renal outcome. This case expands the clinical spectrum of overlapping anti-GBM disease and MN and suggests that patients with MN in remission require long-term serial monitoring for early detection of superimposed autoimmune kidney injury. Individualized immunosuppressive strategies tailored to each patient’s clinical characteristics are essential to optimize kidney outcomes in such complex glomerular diseases.
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BibTeX
@article{cheng2026successful,
title = {{Successful treatment of anti-glomerular basement membrane antibody disease combined with membranous nephropathy using rituximab: a case report}},
author = {Yaqian Cheng and Guojian Shao and LingJiu Shao and ZhouTao Xie and WenWen Hu and Binhui Pan and Yifan Zhang},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1886319},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1886319/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Successful treatment of anti-glomerular basement membrane antibody disease combined with membranous nephropathy using rituximab: a case report
AU - Yaqian Cheng
AU - Guojian Shao
AU - LingJiu Shao
AU - ZhouTao Xie
AU - WenWen Hu
AU - Binhui Pan
AU - Yifan Zhang
PY - 2026
DA - 2026/10/28
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1886319
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1886319/full
AB - Anti‑glomerular basement membrane (anti‑GBM) disease is a rare autoimmune disorder that classically manifests as rapidly progressive glomerulonephritis and pulmonary hemorrhage. The coexistence of anti-GBM disease and membranous nephropathy (MN) was first reported in 1976. Although such cases are rare, many reported patients develop progressive kidney injury and poor renal outcomes. We report a young man with sequential-onset dual glomerulopathy. He initially presented with MN alone and achieved partial remission following glucocorticoid and cyclosporine therapy. Three years later, he developed rapidly progressive glomerulonephritis, and kidney biopsy confirmed anti-GBM disease superimposed on pre-existing MN. This sequential pattern differs from the simultaneous onset of both lesions reported in many previous cases. To minimize gonadal toxicity, he received individualized therapy consisting of glucocorticoids, dose-adjusted cyclophosphamide, rituximab, and plasma exchange. He ultimately recovered normal kidney function and had a favorable renal outcome. This case expands the clinical spectrum of overlapping anti-GBM disease and MN and suggests that patients with MN in remission require long-term serial monitoring for early detection of superimposed autoimmune kidney injury. Individualized immunosuppressive strategies tailored to each patient’s clinical characteristics are essential to optimize kidney outcomes in such complex glomerular diseases.
SN - 1664-3224
ER -