Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigated the differences in clinical characteristics，pathological features and prognosis of antiglomerular basement membrane (GBM) disease combined with IgA nephropathy or membranous nephropathy.
Ｍｅｔｈｏｄｏｌｏｇｙ：From January 2004 to December 2015, seventy five patients with antiGBM disease were enrolled into this retrospective study. According to the pathological diagnosis, the patients were divided into three group, including 10 cases of antiGBM disease with IgA nephropathy (with IgAN group), 5 cases of antiGBM disease with membranous nephropathy (with MN group) and 60 cases of simple antiGBM disease (simple antiGBM disease group). The clinical, laboratory and pathological indices were compared among the three groups.
Ｒｅｓｕｌｔｓ：In patients of antiGBM disease with IgAN group and with MN group, they had lower percents of anuria, while more urine protein and microscope hematuria, and a lower level of antiGBM antibodies, but not statistical significance. Furthermore, the patients in simple antiGBM disease group were more serious in renal dysfunctions, which represented as highest percents of rapidly progressive glomerulonephritis (RPGN) (P=0004), highest levels of hypertension (P=0002), serum creatinine (SCr,P<0001) and a more serious degree of anemia (P<0001). In pathology, the patients in simple antiGBM disease group were observed to have the highest percentage of crescents in glomeruli (P=0008) and Bowmans wall fracture (P=0005). In the course of treatment, the patients in simple antiGBM disease group had the highest proportion of continuous renal replacement therapy（P=0008）. During the followup, the patients in simple antiGBM disease group had the highest percentage of end stage renal disease (ESRD) in one years (P<0001）.
Ｃｏｎｃｌｕｓｉｏｎ：
AntiGBM disease with IgA nephropathy or membranous nephropathy is different from simple antiGBM disease in clinical manifestations, laboratory indices, pathology and prognosis.

Key words: anti-glomerular basement membrane disease, IgA nephropathy, membranous nephropathy, crescentic glomerulonephritis