Case Report: Anti-glomerular basement membrane disease during pregnancy with favorable renal outcome, sequential biopsies, and dual anti-α1/α3(IV) and anti-LM521 antibodies

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A 33-year-old woman developed atypical anti-GBM disease at 13 weeks of gestation, presenting with severe symptoms and acute kidney injury.
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Sequential kidney biopsies showed a reduction in active necrotizing lesions from 64.3% to 30.8% after intensive immunosuppression and pregnancy termination.
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Western blot identified dual autoantibodies against type IV collagen α1/α3 chains and laminin-521, a novel finding in pregnancy-associated anti-GBM disease.
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Multidisciplinary management, including plasma exchange and high-dose methylprednisolone, enabled discontinuation of dialysis and partial renal recovery.
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This case highlights the importance of early intensive immunotherapy and timely obstetric intervention in mitigating disease activity during pregnancy.

Frontiers In Immunology

by Jing Zhuang, Siwen Gu, Yue Qu, Changrong Zhang, Huang Kuang, Zhao Cui, Xuefei Tian, Hong Jiang
June 1, 2026

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