ArticlePediatric nephrology (Berlin, Germany)2026
Severe acute kidney failure due to double-seropositive anti-GBM glomerulonephritis in a child: a case for rituximab therapy.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDouble-seropositive anti-glomerular basement membrane (GBM) disease, characterized by the presence of both anti-GBM and anti-neutrophil cytoplasmic autoantibodies (ANCAs), is extremely rare in children. Double-seropositive patients represent a hybrid phenotype combining the severe acute kidney injury of isolated anti-GBM disease with the relapse risk and subsequent need for maintenance treatment of ANCA-associated vasculitis. CLINICAL PRESENTATION: Here we present the case of an 11-year-old girl presenting with rapidly progressive glomerulonephritis leading to kidney failure and warranting kidney replacement therapy. Anti-GBM antibodies and myeloperoxidase-ANCAs were both detected in serum. Kidney histopathology revealed over 90% crescents. Despite the aggressive presentation, treatment with high-dose corticosteroids, plasmapheresis, and rituximab led to recovery of kidney function and dialysis discontinuation.
conclusionOur case suggests that rituximab, without cyclophosphamide, may represent a promising therapeutic approach in children with double-seropositive anti-GBM disease, even in severe presentations.
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