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Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Long-standing rheumatoid arthritis (RA) complicated by anti\u2013glomerular basement membrane (anti-GBM) disease is exceptionally rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>A 71-year-old man with long-standing seropositive RA developed a rapidly progressive glomerulonephritis due to anti-GBM disease, without any known drug triggers. Despite plasmapheresis (therapeutic plasma exchange), corticosteroids, and low-dose cyclophosphamide, he remained dialysis-dependent; RA activity was subsequently controlled with tocilizumab. Complications included <jats:italic>Stenotrophomonas maltophilia<\/jats:italic> pneumonia, COVID-19 and cytomegalovirus infection, and he died of pneumonia eight months after diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case highlights the need for early serological testing for anti-GBM disease in RA patients with unexplained hematuria\/proteinuria and for immunosuppressive therapy mindful of infection risk. Additionally, our literature review identified only ten reported cases of RA with anti-GBM disease, highlighting the rarity of this condition.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1661117","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T05:29:59Z","timestamp":1760678999000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapidly progressive anti-GBM disease secondary to long-standing rheumatoid arthritis: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Ji","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Guang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadan","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruohan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"B1","article-title":"Renal involvement in patients with rheumatoid arthritis","volume":"56","author":"Galesi\u0107","year":"2009","journal-title":"Reumatizam"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000000302","article-title":"Analysis of 65 renal biopsies from patients with rheumatoid arthritis (1976-2015): change in treatment strategies decreased frequency and modified histopathological findings","volume":"21","author":"Vinicki","year":"2015","journal-title":"J Clin Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2024.103531","article-title":"Epidemiology, clinical features, risk factors, and outcomes in anti-glomerular basement membrane disease: A systematic review and meta-analysis","volume":"23","author":"Kuang","year":"2024","journal-title":"Autoimmun Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1442955","article-title":"Complement in anti-glomerular basement membrane glomerulonephritis","volume":"16","author":"Zhang","year":"2025","journal-title":"Front Immunol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1159\/000184171","article-title":"Goodpasture\u2019s syndrome in a patient receiving penicillamine and carbimazole","volume":"45","author":"Peces","year":"1987","journal-title":"Nephron"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/BF02480657","article-title":"Report of a patient with rheumatoid arthritis developing rapidly progressive glomerulonephritis associated with anti-glomerular basement membrane antibody and antineutrophil cytoplasmic antibody","volume":"1","author":"Hiroshige","year":"1997","journal-title":"Clin Exp Nephrology"},{"key":"B7","first-page":"897","article-title":"A case of Goodpasture syndrome associated with minimal change nephrotic syndrome (MCNS) in a patient with rheumatoid arthritis (RA)","volume":"51","author":"Takeda","year":"2009","journal-title":"Japanese J Nephrology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/art.10891","article-title":"Anti-glomerular basement membrane antibody-associated renal failure in a patient with leflunomide-treated rheumatoid arthritis","volume":"48","author":"Bruyn","year":"2010","journal-title":"Arthritis Rheumatism"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1904","DOI":"10.3899\/jrheum.120325","article-title":"Tumor necrosis factor-\u03b1 inhibitor-induced antiglomerular basement membrane antibody disease in a patient with rheumatoid arthritis","volume":"39","author":"Nishimura","year":"2012","journal-title":"J Rheumatol"},{"key":"B10","first-page":"351A","article-title":"Anti-tumor necrosis factor therapy - 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