{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T01:40:28Z","timestamp":1764639628473,"version":"3.46.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pulmonary\u2010renal syndrome (PRS) caused by double\u2010positive ANCA\u2010associated vasculitis and anti\u2010GBM disease is rare, and management is primarily guided by case series evidence. We present an even rarer case of a 36\u2010year\u2010old female who developed PRS in early pregnancy due to double\u2010positive disease. She required intensive care admission for respiratory support and was treated with high\u2010dose steroids and two doses of rituximab (1\u2009g), achieving a good pulmonary response. However, her renal function subsequently deteriorated. Given the high maternal and foetal risks associated with her condition, she chose to terminate her pregnancy at 8\u2009weeks. A subsequent kidney biopsy revealed crescentic glomerulonephritis secondary to anti\u2010GBM disease. She was treated with plasma exchange and cyclophosphamide, leading to normalisation of her kidney function. She was weaned off prednisone and completed a course of intravenous pulsed cyclophosphamide (500\u2009mg \u00d76 fortnightly). At 1\u2009year post\u2010diagnosis, she remains in biochemical and clinical remission on maintenance rituximab every 6\u2009months. This case highlights the complexity of managing double\u2010positive disease in pregnancy, where evidence is limited, and decisions require careful consideration of maternal and foetal risks. Furthermore, it underscores the importance of early anti\u2010GBM\u2010specific treatment\u2014plasma exchange and cyclophosphamide\u2014in achieving remission.<\/jats:p>","DOI":"10.1111\/nep.70124","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T04:17:19Z","timestamp":1757996239000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Double Positive Anti\u2010\n                    <scp>PR3 ANCA<\/scp>\n                    Vasculitis and Anti\u2010\n                    <scp>GBM<\/scp>\n                    Vasculitis in a Pregnant Woman: Case Report"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0656-9505","authenticated-orcid":false,"given":"Sumedh","family":"Jayanti","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Westmead Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Health and Medicine University 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Sydney New South Wales Australia"},{"name":"Department of Immunopathology ICPMR, NSW Health Pathology  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Westmead Hospital  Sydney New South Wales Australia"},{"name":"Westmead Applied Research Centre, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Centre for Kidney Research, School of Public Health The University of Sydney  Sydney New South Wales 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