{"id":"https://openalex.org/W7203695589","doi":"https://doi.org/10.2169/internalmedicine.7718-26","title":"Anti-Glomerular Basement Membrane Antibody Disease Complicated by Complement-Mediated Thrombotic Microangiopathy: A Case Report","display_name":"Anti-Glomerular Basement Membrane Antibody Disease Complicated by Complement-Mediated Thrombotic Microangiopathy: A Case Report","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7203695589","doi":"https://doi.org/10.2169/internalmedicine.7718-26","pmid":"https://pubmed.ncbi.nlm.nih.gov/42618268"},"language":"en","primary_location":{"id":"doi:10.2169/internalmedicine.7718-26","doi":"https://doi.org/10.2169/internalmedicine.7718-26","is_oa":true,"landing_page_url":"https://doi.org/10.2169/internalmedicine.7718-26","pdf_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7718-26/_pdf","source":{"id":"https://openalex.org/S154471048","display_name":"Internal Medicine","issn_l":"0918-2918","issn":["0918-2918","1349-7235"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313351","host_organization_name":"The Japanese Society of Internal Medicine","host_organization_lineage":["https://openalex.org/P4310313351"],"host_organization_lineage_names":["The Japanese Society of Internal Medicine"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7718-26/_pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5092611701","display_name":"Ryo Okino","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ryo Okino","raw_affiliation_strings":["Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112931744","display_name":"Yoshitada Toyota","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yoshitada Toyota","raw_affiliation_strings":["Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5011044330","display_name":"Takaaki Kaji","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Takaaki Kaji","raw_affiliation_strings":["Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004255843","display_name":"Ryo Nishioka","orcid":"https://orcid.org/0000-0001-8654-7311","observed_orcids":["https://orcid.org/0000-0001-8654-7311"]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ryo Nishioka","raw_affiliation_strings":["Department of General Medicine, Kanazawa University Hospital, Japan","Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of General Medicine, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]},{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5072013505","display_name":"Ichiro Mizushima","orcid":"https://orcid.org/0000-0002-6231-0683","observed_orcids":["https://orcid.org/0000-0002-6231-0683"]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ichiro Mizushima","raw_affiliation_strings":["Department of General Medicine, Kanazawa University Hospital, Japan","Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of General Medicine, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]},{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5078776603","display_name":"Norihiko Sakai","orcid":"https://orcid.org/0000-0001-7245-9716","observed_orcids":["https://orcid.org/0000-0001-7245-9716"]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Norihiko Sakai","raw_affiliation_strings":["Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","Division of Blood Purification Therapy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]},{"raw_affiliation_string":"Division of Blood Purification Therapy","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5005250682","display_name":"Yasunori Iwata","orcid":"https://orcid.org/0000-0002-4756-5207","observed_orcids":["https://orcid.org/0000-0002-4756-5207"]},"institutions":[{"id":"https://openalex.org/I4210104330","display_name":"Kanazawa University Hospital","ror":"https://ror.org/00xsdn005","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210104330"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yasunori Iwata","raw_affiliation_strings":["Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology and Rheumatology, Kanazawa University Hospital, Japan","institution_ids":["https://openalex.org/I4210104330"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I4210104330"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.51949369,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10993","display_name":"Complement system in diseases","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2403","display_name":"Immunology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10993","display_name":"Complement system in diseases","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2403","display_name":"Immunology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/thrombotic-microangiopathy","display_name":"thrombotic microangiopathy","score":0.9150000214576721},{"id":"https://openalex.org/keywords/eculizumab","display_name":"eculizumab","score":0.8830000162124634},{"id":"https://openalex.org/keywords/anti-c5-monoclonal-antibody","display_name":"anti-C5 monoclonal antibody","score":0.8859999775886536},{"id":"https://openalex.org/keywords/hemolytic-anemia","display_name":"hemolytic anemia","score":0.9020000100135803},{"id":"https://openalex.org/keywords/thrombocytopenia","display_name":"thrombocytopenia","score":0.9610000252723694},{"id":"https://openalex.org/keywords/therapeutic-plasma-exchange","display_name":"plasma exchange","score":0.5839999914169312}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9441999793052673},{"id":"https://openalex.org/C159654299","wikidata":"https://www.wikidata.org/wiki/Q79460","display_name":"Antibody","level":2,"score":0.5565000176429749},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.527999997138977},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.44190001487731934},{"id":"https://openalex.org/C2776193487","wikidata":"https://www.wikidata.org/wiki/Q32846","display_name":"Basement membrane","level":2,"score":0.4104999899864197},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.3467999994754791},{"id":"https://openalex.org/C2780648854","wikidata":"https://www.wikidata.org/wiki/Q2745824","display_name":"Immunopathology","level":2,"score":0.32899999618530273},{"id":"https://openalex.org/C2777234017","wikidata":"https://www.wikidata.org/wiki/Q1345792","display_name":"Goodpasture syndrome","level":5,"score":0.30550000071525574},{"id":"https://openalex.org/C163764329","wikidata":"https://www.wikidata.org/wiki/Q785022","display_name":"Autoantibody","level":3,"score":0.301800012588501},{"id":"https://openalex.org/C2777466421","wikidata":"https://www.wikidata.org/wiki/Q1266890","display_name":"Vascular disease","level":2,"score":0.28459998965263367},{"id":"https://openalex.org/C2776670291","wikidata":"https://www.wikidata.org/wiki/Q1779300","display_name":"Connective tissue disease","level":4,"score":0.26510000228881836},{"id":"https://openalex.org/C159047783","wikidata":"https://www.wikidata.org/wiki/Q7215","display_name":"Virology","level":1,"score":0.26460000872612},{"id":"https://openalex.org/C2779075594","wikidata":"https://www.wikidata.org/wiki/Q8084905","display_name":"Autoimmune disease","level":3,"score":0.2578999996185303},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.257099986076355}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.2169/internalmedicine.7718-26","doi":"https://doi.org/10.2169/internalmedicine.7718-26","is_oa":true,"landing_page_url":"https://doi.org/10.2169/internalmedicine.7718-26","pdf_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7718-26/_pdf","source":{"id":"https://openalex.org/S154471048","display_name":"Internal Medicine","issn_l":"0918-2918","issn":["0918-2918","1349-7235"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313351","host_organization_name":"The Japanese Society of Internal Medicine","host_organization_lineage":["https://openalex.org/P4310313351"],"host_organization_lineage_names":["The Japanese Society of Internal Medicine"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal Medicine","raw_type":"journal-article"},{"id":"pmid:42618268","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42618268","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal medicine (Tokyo, Japan)","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.2169/internalmedicine.7718-26","doi":"https://doi.org/10.2169/internalmedicine.7718-26","is_oa":true,"landing_page_url":"https://doi.org/10.2169/internalmedicine.7718-26","pdf_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7718-26/_pdf","source":{"id":"https://openalex.org/S154471048","display_name":"Internal Medicine","issn_l":"0918-2918","issn":["0918-2918","1349-7235"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313351","host_organization_name":"The Japanese Society of Internal Medicine","host_organization_lineage":["https://openalex.org/P4310313351"],"host_organization_lineage_names":["The Japanese Society of Internal Medicine"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7203695589.pdf","grobid_xml":"https://content.openalex.org/works/W7203695589.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4385258867","https://openalex.org/W7163874923","https://openalex.org/W4396999484","https://openalex.org/W4377220918","https://openalex.org/W4309859591","https://openalex.org/W2515590332","https://openalex.org/W1974078994","https://openalex.org/W2734360594","https://openalex.org/W3167098354","https://openalex.org/W4383619212"],"abstract_inverted_index":{"Anti-glomerular":[0],"basement":[1],"membrane":[2],"(GBM)":[3],"antibody":[4,29],"disease":[5],"rarely":[6],"causes":[7],"thrombotic":[8],"microangiopathy":[9],"(TMA).":[10],"We":[11],"herein":[12],"report":[13],"the":[14,77],"case":[15],"of":[16],"a":[17],"75-year-old":[18],"Japanese":[19],"woman":[20],"who":[21],"developed":[22],"refractory":[23,90],"TMA":[24,33,84],"during":[25],"treatment":[26],"for":[27,60],"anti-GBM":[28],"disease.":[30],"Although":[31],"secondary":[32],"was":[34,55,64],"initially":[35],"suspected,":[36],"persistent":[37],"hemolytic":[38],"anemia":[39],"and":[40,46,73,92],"thrombocytopenia":[41],"despite":[42],"plasma":[43],"exchange,":[44],"glucocorticoids,":[45],"cyclophosphamide":[47],"led":[48],"us":[49],"to":[50],"suspect":[51],"complement-mediated":[52],"TMA.":[53],"Eculizumab":[54],"initiated":[56],"after":[57],"genetic":[58,74],"testing":[59,75],"complement":[61],"regulatory":[62],"factors":[63],"performed.":[65],"The":[66],"patient":[67],"became":[68],"transfusion-independent":[69],"within":[70],"one":[71],"week,":[72],"identified":[76],"c.293C\uff1eT":[78],"(p.Thr98Ile)":[79],"variant":[80],"in":[81,89],"CD46.":[82],"Complement-mediated":[83],"should":[85],"thus":[86],"be":[87,97],"considered":[88],"cases,":[91],"anti-C5":[93],"monoclonal":[94],"antibodies":[95],"may":[96],"an":[98],"effective":[99],"therapeutic":[100],"option.":[101]},"counts_by_year":[],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2026-08-19T00:00:00"}