Nature clinical practice. Nephrology · 2006
Interpretation of serologic tests in an HIV-infected patient with kidney disease.
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Hernandez German T, Critchfield Jeffrey M, Rodriguez Rudolph A
Аннотация
BACKGROUND: A 32-year-old African American man with HIV infection presented with hemoptysis, shortness of breath and renal insufficiency. Serologic testing revealed the presence of anti-glomerular basement membrane antibodies and equivocal levels of anti-myeloperoxidase antibodies.
INVESTIGATIONS: Physical examination, urine and blood analysis, kidney ultrasound, chest radiograph, sputum cultures, bronchoscopy and renal biopsy.
DIAGNOSIS: Reactivation of tuberculosis infection, immune complex glomerulonephritis, and 'false-positive' anti-glomerular basement membrane and anti-myeloperoxidase antibodies.
MANAGEMENT: Directly observed therapy with four-drug anti-tuberculosis therapy and conservative management of chronic kidney disease.
INVESTIGATIONS: Physical examination, urine and blood analysis, kidney ultrasound, chest radiograph, sputum cultures, bronchoscopy and renal biopsy.
DIAGNOSIS: Reactivation of tuberculosis infection, immune complex glomerulonephritis, and 'false-positive' anti-glomerular basement membrane and anti-myeloperoxidase antibodies.
MANAGEMENT: Directly observed therapy with four-drug anti-tuberculosis therapy and conservative management of chronic kidney disease.