Analysis of clinical and pathological features and prognosis of anti-glomerular basement membrane disease with mem-branous nephropathy
Yang Xiaoxia
Sun Shiren
Zhao Jing
Yu Yan
Abstract：Objective To investigate the clinical manifestations,pathological features and prognosis of anti-glomerular basement membrane(anti-GBM)disease with membranous nephropathy(MN),and to provide a reference for the diagnosis and treatment of this rare disease.Methods A retrospective analysis was conducted on 58 patients diagnosed with anti-GBM disease via renal biopsy at our center between January 2016 and December 2024.Enrolled subjects included 34 patients with anti-GBM glomerulonephritis,16 with anti-GBM disease and concurrent anti-neutrophil cytoplasmic antibody-as-sociated vasculitis(anti-GBM+ANCA)and 8 with anti-GBM disease and MN(anti-GBM+MN).Laboratory tests and patho-logical information were analyzed among the three groups,and prognosis was assessed through continuous follow-up.Renal survival rates were calculated using the Kaplan-Meier method.Results The average age of enrolled subjects was over 45 years,and no significant gender differences were observed.Hemoptysis occurred in 14.7％(5/34)of the anti-GBM group and 18.7％(3/16)of the anti-GBM+ANCA group,while no hemoptysis was exhibited in the anti-GBM+MN group.Compared with patients with classical anti-GBM and anti-GBM+ANCA disease,those with anti-GBM disease with MN presented a lower incidence of acute kidney injury(AKI),no hemoptysis,and higher hemoglobin levels(P=0.011).The proportion of glomerular crescents in the anti-GBM+MN group was significantly lower than in the other two groups(P＜0.001).75％(6/8)of cases were positive for circulating anti-PLA2R and 87.5％(7/8)of cases showed positive PLA2R staining in renal tis-sue.Survival curve analysis revealed that renal outcomes in the anti-GBM+MN group were better than those in the anti-GBM and anti-GBM+ANCA groups(P=0.049).Conclusion Patients with both anti-GBM disease and MN showed atypical anti-GBM disease.They had a lower proportion of glomerular crescents and a better renal function prognosis than patients with classical anti-GBM.Early identification and treatment of anti-GBM disease associated with MN are needed to improve renal recovery.
Keywords：Anti-glomerular basement membraneMembranous nephropathyAnti-neutrophil cytoplasmic antibodiesCrescentPrognosis
Publication Date：2026-02-18
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：6( 185-190 )