Anti GBM disease in patient with Membranous nephropathy

Crescentic transformation of primary membranous nephropathy (MN) due to anti-Glomerular basement membrane antibody (anti-GBM antibody) is a rare cause of acute renal failure in patients with MN. This is a case report of 19 - year old gentleman who was initially diagnosed with Membranous nephropathy presented one year later with accelerated hypertension and rapidly progressive renal failure(RPRF). His serum antiGBM antibody was positive. Renal biopsy revealed circumferential crescents in all glomeruli with linear IgG staining by immunofluorescence. Patient was treated with steroids, oral cyclophosphamide and plasmapheresis. Due to non-recovery of renal function he became dialysis dependant and died nine months later. Though anti-GBM antibody is a well known cause of RPRF in patients with MN less very few cases have been reported so far. This case is presented for its rarity.