{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:58:20Z","timestamp":1785499100111,"version":"3.56.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"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. Med."],"abstract":"<jats:p>Anti-glomerular basement membrane (GBM) antibody disease is an autoimmune-mediated rapidly progressive renal injury. The coexistence of diffuse non-hereditary glomerular basement membrane thinning of uncertain etiology in elderly patients is clinically rare and poses substantial challenges in differential diagnosis and clinical management. We herein report a 70-year-old female patient admitted for elevated serum creatinine for more than 20 days. After a prodromal infection, she rapidly progressed to anuria and acute kidney injury (AKI), with markedly elevated serum anti-GBM antibody levels. Renal biopsy revealed crescentic glomerulonephritis, and electron microscopy demonstrated diffuse thinning of the glomerular basement membrane; genetic testing excluded hereditary thin basement membrane nephropathy. The patient received methylprednisolone pulse therapy, cyclophosphamide immunosuppression, plasma exchange, and maintenance hemodialysis. Long-term dynamic monitoring of antibody levels and imaging indicators was performed after discharge. During hospitalization and follow-up, anti-GBM antibody levels declined continuously, subsequent infection was gradually controlled by antimicrobial therapy, and the patient remained hemodialysis-dependent with stable overall condition. Renal biopsy combined with genetic testing is the core method to distinguish lesions of diffuse non-hereditary glomerular basement membrane thinning of uncertain etiology, from hereditary basement membrane lesions. This case represents an elderly patient with oligoimmune atypical anti-GBM antibody disease and diffuse non-hereditary glomerular basement membrane thinning of uncertain etiology, and this long-term follow-up record provides valuable clinicopathological reference for individualized treatment and prognostic evaluation of similar rare cases.<\/jats:p>","DOI":"10.3389\/fmed.2026.1883699","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:10:24Z","timestamp":1785496224000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Elderly anti-GBM antibody disease with diffuse non-hereditary glomerular basement membrane thinning of uncertain etiology"],"prefix":"10.3389","volume":"13","author":[{"given":"Pei","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Weiwei","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqiong","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Affiliated Hospital of 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