Anti-glomerular basement membrane
antibodies are significantly specific for detecting
anti-glomerular basement membrane disease. These
antibodies are typically targeted against the non-collagenous (NC1) domain of the alpha 3 chain of
type IV collagen and, to a lesser extent, the α4(IV) or α5(IV) chains, which create a triple-helical structure in the glomerular basement membrane. The modification of the hexameric structure of NC1 (α3(IV)) results in the exposure of new
epitopes, leading to an immune reaction and the subsequent deposition of linear
antibodies along the glomerular basement membrane, culminating in crescentic
glomerulonephritis. Anti-glomerular basement membrane
antibodies that are positive are believed to be pathogenic and capable of binding to the glomerular basement membrane in vivo, particularly in the context of rapidly progressive
glomerulonephritis. Herein, we present a patient with positive serum anti-glomerular basement membrane
antibodies but negative
IgG deposition. The current findings are significant for raising physicians' awareness of the probable errors in detecting
anti-glomerular basement membrane antibody disease as a possible cause of irreversible
kidney failure.