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Case Reports in Nephrology
Volume 2017 (2017), Article ID 7143649, 5 pages
Case Report

Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence

1Department of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
2Central Laboratory, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan

Correspondence should be addressed to Yoshihide Fujigaki

Received 21 July 2017; Accepted 30 August 2017; Published 11 October 2017

Academic Editor: Kouichi Hirayama

Copyright © 2017 Yoshihide Fujigaki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 26-year-old man highly suspected of having antiglomerular basement membrane (GBM) disease was treated with corticosteroid pulse therapy 9 days after initial infection-like symptoms with high procalcitonin value. The patient required hemodialysis the next day of the treatment due to oliguria. In addition to corticosteroid therapy, plasmapheresis was introduced and the patient could discontinue hemodialysis 43 days after the treatment. Kidney biopsy after initiation of hemodialysis confirmed anti-GBM disease with 86.3% crescent formation. Physician should keep in mind that active anti-GBM disease shows even high procalcitonin value in the absence of infection. To pursue recovery of renal function, the challenge of the immediate and persistent treatment with high-dose corticosteroids plus plasmapheresis for highly suspected anti-GBM disease is vitally important despite the presence of reported predictors for dialysis-dependence including oliguria and requiring hemodialysis at presentation.