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  • Double-positive with positive anti-glomerular basement membrane antibody and ANCA-positive disease in a patient with dermatomyositis

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Rare disease
CASE REPORT
Double-positive with positive anti-glomerular basement membrane antibody and ANCA-positive disease in a patient with dermatomyositis
  1. Eric J Dein1,
  2. Monica Crespo-Bosque2,
  3. Homa Timlin3,
  4. Duvuru Geetha4
  1. 1Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA
  2. 2Rheumatology, Johns Hopkins Hospital and Health System, Baltimore, Maryland, USA
  3. 3Rheumatology, Johns Hopkins, Baltimore, Maryland, USA
  4. 4Nephrology, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Homa Timlin, htimlin1{at}jhmi.edu

Summary

Approximately one in four patients (23.3%) with inflammatory myositis including dermatomyositis can require evaluation for acute kidney injury. The main cause of kidney injury is acute tubular necrosis from medications or myoglobinuria, though clinicians should be aware of a wide variety of possible aetiologies. We present the case of a 44-year-old woman with stable anti-Jo1 dermatomyositis, who presented with acute kidney injury. During her hospital course, she was diagnosed with double-positive disease characterised by circulating anti-glomerular basement membrane antibody and myeloperoxidase antineutrophil cytoplasmic antibody and renal biopsy revealing crescentic glomerulonephritis with linear staining of capillary wall for IgG.

  • muscle disease
  • vasculitis

https://doi.org/10.1136/bcr-2018-224475

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    Footnotes

    • Contributors EJD conducted a literature review and wrote the initial draft of the case report. MCB, DG and HT were all integral in reviewing and editing the case report with their additions incorporated into the final paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.