Fig. 1

Clinical course of present case. The patient was admitted to our hospital with high fever and oliguria. At the time of his visit, he was accompanied by a markedly elevated serum creatinine and was immediately started on GC pulse and PE therapy. He also underwent concomitant hemodialysis for severe renal impairment. Subsequently, high levels of anti-GBM antibody was detected and anti-GBM GN was diagnosed. With these treatments, his renal function quickly improved, proteinuria and serum GBM antibodies became negative, and he was discharged on the 46th day of hospitalization. However, 2 months later, he had a relapse with positive anti-GBM antibody and increased proteinuria. He was admitted to our hospital again and received GC pulse and PE, plus IVCY therapy. As a result, the patient was again in remission and discharged from our hospital. sCr: serum creatinine, GC: glucocorticoid, PE: plasma exchange therapy, HD: hemodialysis, S.I: selectivity index, EM: electro-microscopy, m-PSL: methyl-prednisolone, GBM: glomerular basement membrane antibody, CRP: c-reactive protein, anti-GBM GN: anti-glomerular basement membrane glomerulonephritis, IVCY: intravenous cyclophosphamide