{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:02:26Z","timestamp":1780293746177,"version":"3.54.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Anti-glomerular basement membrane (anti-GBM) disease during pregnancy is rare and often life-threatening. We report a G4P1 woman who developed atypical anti-GBM disease at 13 weeks of gestation. Serial kidney biopsies demonstrated a reduction in active necrotizing lesions from 64.3% to 30.8% following early intensive immunosuppression and pregnancy termination. Western blot identified circulating autoantibodies against type IV collagen \u03b11\/\u03b13 chains and laminin-521 (LM-521)\u2014a novel finding in anti-GBM disease during pregnancy. Multidisciplinary management, including plasma exchange, high-dose methylprednisolone, hemodialysis, pregnancy termination, and obinutuzumab for serologic recurrence, enabled discontinuation of dialysis and partial renal recovery with stable kidney function. This case provides histological evidence, through sequential kidney biopsies, that early intensive immunotherapy combined with pregnancy termination can halt active necrotizing lesions and facilitate tissue repair. It also examines the potential association between specific autoantibody subtypes (anti-\u03b11\/\u03b13 chains and LM521) and disease phenotypes, offering new insights into anti-GBM disease during pregnancy.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1714790","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:24:42Z","timestamp":1780291482000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Anti-glomerular basement membrane disease during pregnancy with favorable renal outcome, sequential biopsies, and dual anti-\u03b11\/\u03b13(IV) and anti-LM521 antibodies"],"prefix":"10.3389","volume":"17","author":[{"given":"Jing","family":"Zhuang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, People\u2019s Hospital of Xinjiang Uygur Autonomous Region","place":["Urumqi, 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