Association of anti-glomerular basement membrane antibody disease with dermatomyositis and psoriasis: case report

Association of anti-glomerular basement membrane antibody disease with dermatomyositis and psoriasis: case report

Alternative title Associação de doença do anticorpo anti-membrana basal glomerular com dermatomiosite e psoríase: relato de caso
Author Machado, Natália Pereira Autor UNIFESP Google Scholar
Camargo, Cintia Zumstein Autor UNIFESP Google Scholar
Oliveira, Ana Cecília Diniz Autor UNIFESP Google Scholar
Buosi, Ana Letícia Pirozzi Autor UNIFESP Google Scholar
Pucinelli, Mário Luiz Cardoso Autor UNIFESP Google Scholar
Souza, Alexandre Wagner Silva de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract CONTEXT: Anti-glomerular basement membrane (anti-GBM) antibody syndrome is characterized by deposition of anti-GBM antibodies on affected tissues, associated with glomerulonephritis and/or pulmonary involvement. This syndrome has been described in association with other autoimmune disorders, but as far as we know, it has not been described in association with dermatomyositis and psoriasis. CASE REPORT: A 51-year-old man with a history of dermatomyositis and vulgar psoriasis presented with a condition of sensitive-motor polyneuropathy of the hands and feet, weight loss of 4 kg, malaise and fever. On admission, he had been making chronic use of cyclosporin and antihypertensive drugs for three months because of mild arterial hypertension. Laboratory tests showed anemia and leukocytosis, elevated serum urea and creatinine and urine presenting proteinuria, hematuria, leukocyturia and granular casts. The 24-hour proteinuria was 2.3 g. Renal biopsy showed crescentic necrotizing glomerulonephritis with linear immunoglobulin G (IgG) deposits on the glomerular basement membrane by means of direct immunofluorescence, which were suggestive of anti-GBM antibodies. The patient was then treated initially with methylprednisolone and with monthly cyclophosphamide in the form of pulse therapy.

CONTEXTO: A síndrome do anticorpo anti-membrana basal glomerular (anti-MBG) é caracterizada pela deposição de anticorpos anti-MBG em tecidos afetados, associada à glomerulonefrite e/ou ao envolvimento pulmonar. Essa síndrome já foi descrita em associação a outras doenças autoimunes, mas até onde conhecemos, não há relatos de sua associação com dermatomiosite e psoríase. RELATO DE CASO: Um homem de 51 anos com antecedentes de dermatomiosite e psoríase vulgar apresentou quadro de polineuropatia sensitivo-motora de mãos e pés, perda de 4 kg, adinamia e febre. À admissão estava em uso crônico de ciclosporina e de anti-hipertensivos há três meses devido a hipertensão arterial leve. Exames laboratoriais mostraram anemia e leucocitose, creatinina e ureia séricas elevadas e urina com proteinúria, hematúria, leucocitúria e cilindros granulosos. A proteinúria de 24 horas foi de 2,3 g. A biópsia renal revelou uma glomerulonefrite crescêntica necrotizante com depósitos lineares de imunoglobulina G (IgG) na MBG à imunofluorescência, sugestivos de anticorpos anti-MBG. O paciente foi então tratado inicialmente com metilprednisolona e com ciclofosfamida mensalmente na forma de pulsoterapia.
Keywords Psoriasis
Dermatomyositis
Anti-glomerular basement membrane disease
Antibodies, antineutrophil cytoplasmic
Glomerulonephritis
Psoríase
Dermatomiosite
Doença antimembrana basal glomerular
Anticorpos anticitoplasma de neutrófilos
Glomerulonefrite
Language English
Date 2010-01-01
Published in São Paulo Medical Journal. Associação Paulista de Medicina - APM, v. 128, n. 5, p. 306-308, 2010.
ISSN 1516-3180 (Sherpa/Romeo, impact factor)
Publisher Associação Paulista de Medicina - APM
Extent 306-308
Origin http://dx.doi.org/10.1590/S1516-31802010000500012
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000285506000012
SciELO ID S1516-31802010000500012 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/5514

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