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Interpretation of serologic tests in an HIV-infected patient with kidney disease
German T Hernandez1, Jeffrey M Critchfield, Rudolph A Rodriguez
1Texas Tech Health Sciences Center at El Paso, Department of Internal Medicine, 4800 Alberta Avenue, El Paso, TX 79905, USA. german.hernandez@ttuhsc.edu
Background:
A 32-year-old African American man with HIV infection presented with hemoptysis, shortness of breath and renal insufficiency. Serologic testing revealed the presence of anti-glomerular basement membrane antibodies and equivocal levels of anti-myeloperoxidase antibodies.
Investigations:
Physical examination, urine and blood analysis, kidney ultrasound, chest radiograph, sputum cultures, bronchoscopy and renal biopsy.
Diagnosis:
Reactivation of tuberculosis infection, immune complex glomerulonephritis, and 'false-positive' anti-glomerular basement membrane and anti-myeloperoxidase antibodies.
Management:
Directly observed therapy with four-drug anti-tuberculosis therapy and conservative management of chronic kidney disease.
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