Challenges in Management of Renal Failure due to Glomerulonephritis associated with Serine Proteinase 3 and Myeloperoxidase Anti Neutrophilic Cytoplasmic Antibodies and Anti-Glomerular Basement Membrane Antibody in a Jehovah’s Witness
Abstract
Triple-seropositive disease (TPD), defined here as concurrent MPO-ANCA, PR3-ANCA, and anti-GBM antibodies, is rare and typically severe.We report a 71-year-old Jehovah's Witness who presented with advanced kidney failure and a large pericardial effusion.Serology confirmed triple positivity, but kidney biopsy tissue was markedly limited.Plasma exchange (PLEX) was declined on religious grounds.Induction was therefore undertaken with high-dose glucocorticoids and rituximab, coordinated with hemodialysis and bloodless-medicine strategies.Despite therapy, she remained dialysis dependent.This case highlights pragmatic, preference-concordant management in the setting of sparse tissue, triple seropositivity, and refusal of PLEX.
Fields of Study & Subjects
Vasculitis and related conditions
Renal Diseases and Glomerulopathies
Systemic Lupus Erythematosus Research
Publication details
- Journal / source
- Medical & Clinical Case Reports Journal
- Volume
- 4
- Issue
- 1
- Pages
- 1590–1593
- Publication date
- 26 February 2026
- Language
- EN