Abstract
Background
Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disorder that specifically affects the kidneys and lungs with the presence of autoantibodies targeting the GBM, causing rapid glomerulonephritis and alveolar hemorrhage due to damage to the capillary bed. The anti-GBM disease secondary with pulmonary Candida albicans infection has been rarely documented.
Case presentation:
A 58-year-old male suspected of tuberculosis presented to our hospital with cough and hemoptysis that progressed to acute respiratory failure and acute renal failure. He was finally diagnosed with invasive C. albicans pneumonia by detection of C. albicans with sputum culture and metagenomic next-generation sequencing (mNGS) in bronchoalveolar lavage fluid (BALF). Diagnosis of anti-GBM disease was confirmed based on positive serum anti-GBM autoantibody levels and diffuse linear spherical IgG deposition along the glomerular capillary walls observed during renal biopsy. After receiving antifungal therapy, plasmapheresis, hemodialysis, corticosteroid shock therapy and cyclophosphamide, the patient achieved a favorable prognosis after discharge.
Conclusion
Our report highlight the association between invasive C. albicans pneumonia and anti-GBM disease, which has not been reported to the best of our knowledge. Our findings suggest that evaluating anti-GBM antibody levels and conducting renal biopsies in elderly patients presenting with hemoptysis and acute renal failure may facilitate the identification of such cases. It is crucial for intensive care unit personnel to be knowledgeable about this syndrome, as initiating appropriate treatment promptly can significantly reduce mortality rates.