Antiglomerular basement membrane nephritis after solvent exposure

A rapidly progressive glomerulonephritis with definitive anuria was observed after solvent inhalation in two young women, aged 22 and 17 years. In both cases the renal biopsy specimen showed diffuse epithelial crescents in all glomeruli, with linear deposits of IgG along the glomerular basement membrane (GBM). High circulating anti-GBM antibody levels were found in sera by indirect immunofluorescence and radioimmunoassay. No anti-alveolar basement membrane antibodies were detectable by immunofluorescent microscopy in one patient. It is suggested that the solvent inhalation resulted in a chemical alteration of the alveolar basement membrane giving rise to anti-basement membrane antibodies, some of which may have cross-reacted with the GBM and initiated the glomerulonephritis.