Table 1.
Cases of Anti-Glomerular Basement Membrane Disease Post SARS-CoV2 Infection
| Case 1 | Case 2 | Case 3 | Case 4 | |
|---|---|---|---|---|
| Age/Gender | 36/F | 18/M | 52/M | 32/F |
| Comorbidity | Nil | Nil | Hypertensive | Nil |
| Smoking status | Nil | Nil | Smoker | Nil |
| Clinical presentation | Lethargy, hematuria, vomiting | Headache, accelerated hypertension | Volume overload, vomiting | Volume overload, fever, hematuria, oliguria |
| Preceding clinical SARS-CoV2 infection | Present – mild | Present – moderate | Present – mild | Present – moderate |
| Prodrome duration | 4 weeks | 8 weeks | 6 weeks | 4 weeks |
| Alveolar hemorrhage | Absent | Absent | Absent | Absent |
| Hemoglobin | 7.8 g/dl | 11g/dl | 8g/dl | 8.2g/dl |
| Renal syndrome | AKI | AKI-RRT | AKI-RRT | AKI-RRT |
| Platelets | 2,30,000/mm3 | 1,25,000/mm3 | 1,50,000/mm3 | 1,12,000/mm3 |
| Serum creatine | 3.4mg/dl | 7mg/dl | 12mg/dl | 16mg/dl |
| C-reactive protein | 0.7 mg/L | 15 mg/L | 4 mg/L | 65 mg/L |
| Anti-GBM titre (IU/mL; normal <6.9) | 287 | 567 | 323 | 386 |
| ANCA | Negative | Positive (p-ANCA) | Negative | Negative |
| Renal Biopsy | Crescentric glomerular Nephritis, no interstitial fibrosis and tubular atrophy, linear IgG staining | Cellular and fibrocellular crescents, linear IgG staining, no interstitial fibrosis and tubular atrophy | Circumferential fibrocellular and cellular crescents, linear IgG staining, IFTA 40% | Cellular and fibrocellular crescents, linear IgG staining, no interstitial fibrosis and tubular atrophy |
| SARS-CoV2 | ||||
| 1. RTPCR | 1. Negative | 1. Negative | 1. Negative | 1. Negative |
| 2. IgG antibody | 2. Negative | 2. Negative | 2. Positive | 2. Negative |
| 3. IgM antibody | 3. Positive | 3 .Positive | 3. Positive | 3. Positive |
| Treatment | Plasma exchange, steroids | Plasma exchange, steroids, cyclophosphamide | Plasma exchange, steroids, cyclophosphamide | Plasma exchange, steroids, cyclophosphamide |
| Outcome | Outpatient follow-up | Outpatient follow-up | On weekly twice RRT | Inpatient RRT |
| Last creatinine | 3.8mg/dl | 5mg/dl | 5.8mg/dl | 6.8mg/dl |