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Fibrillary glomerulonephritis presenting as rapidly progressive glomerulonephritis
Purva Sharma1, Michael Kuperman, Lorraine Racusen
1Johns Hopkins Medical Institutions, Baltimore, MD, USA. psharm16@jhmi.edu
Abstract:
Fibrillary glomerulonephritis (GN) is an uncommon cause of rapidly progressive kidney failure. We report a case of rapidly progressive kidney failure with kidney biopsy showing crescentic GN on light microscopy and immunofluorescence showing linear/globular glomerular basement membrane (GBM) staining for immunoglobulin G and C3, consistent with anti-GBM disease. However, electron microscopy showed fibrillary deposits in the GBM, suggesting a diagnosis of fibrillary GN. As exemplified by this case, it is important to consider fibrillary GN in the differential diagnosis of crescentic GN with linear immunoglobulin G deposits within the GBM. Electron microscopy is crucial to make this diagnosis.
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