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Relapse of treated anti-GBM disease following hair dye use
  1. James Povey1,
  2. Elaine Rutherford1,2,
  3. Jeremy Levy3 and
  4. Thalakunte Muniraju1
  1. 1Department of Nephrology, NHS Dumfries and Galloway, Dumfries, UK
  2. 2Institute of Medical and Cardiovascular Sciences, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
  3. 3Renal Department, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Thalakunte Muniraju; Thalakunte.Muniraju{at}


An 18-year-old woman was treated for acute kidney injury (AKI) secondary to antiglomerular basement membrane (GBM) disease with prednisolone, cyclophosphamide and plasma exchange. She also had epistaxis at initial presentation with no other organ involvement and achieved good recovery of her kidney function. Two weeks after completing induction treatment, she re-presented with further AKI and pulmonary haemorrhage. She was recommenced on plasma exchange and steroids and was given rituximab. She recovered from her illness with significant improvement to her kidney function. The cause of her relapse was thought to be possibly due to the use of hair dye. This case highlights the importance of acknowledging potential environmental exposures to prevent relapses of disease. We were also able to demonstrate a case of successful treatment of anti-GBM disease with rituximab.

  • acute renal failure
  • renal medicine
  • haematuria
  • respiratory medicine
  • renal system

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  • Contributors Conception and design: TM. Drafting of the article: JP. Critical revision of the article for important intellectual content: ER, JL and TM. Final approval of the version published: ER, JL and TM. Changes to the report as per reviewers' comments and suggestions: TM and ER. Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved: all authors.

  • 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.

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

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