Glomerular Basment Membrane Antobodies

Special Precautions/Comments:

Method: FEIA performed on Phadia 250. Calibration: N/A. EQA scheme: UK NEQAS scheme for Neutrophil cytoplasmic and GBM antibodies. IQC: Commercial preparation

Interferences: None known

Interpretation: A negative result should not be used as a sole criterion to rule out Goodpasture’s syndrome or other autoimmune disease. Therefore the GBM antibody test should not be relied upon as the only diagnostic tool and must be used in conjunction with evaluation of clinical symptoms and other evidence.

Additional Information:

Indication: Rapidly progressive glomerulonephritis (RPGN) and Goodpasture’s Syndrome.

Background Information: Glomerular basement membrane (GBM) antibodies are directed towards the non-collagenous domains of type IV collagen. They are associated with glomerulonephritis (GN), most often rapidly progressive glomerulonephritis (RPGN) and Goodpasture’s syndrome (GS). There is evidence to suggest these antibodies are pathogenic and that they correlate with severity of disease [1]. There are reports of natural antibodies to the glomerular basement membrane which can occur in normal individuals [2]. Patients with GBM antibodies may also have anti-neutrophil cytoplasmic antibodies with a P-ANCA pattern usually due to myeloperoxidase antibodies although the significance of this is unclear. Therefore the screen in those patients that have glomerulonephritis and/or pulmonary haemorrhage should include ANCA and GBM antibodies [3

References: Sinclair D, Stevens JM. Role of anti-neutrophil cytoplasmic antibodies and glomerular basement membrane antibodies in the diagnosis and monitoring of systemic vasculitides. Annals Clinical Biochemistry. 2007. 44(5): 432-42. Cui Z, Wang HY, Zhao MH. Natural autoantibodies against glomerular basement membrane exist in normal human sera. Kidney Int. 2006. 69:894-899. [Ref 2] Levy JB, et al. Clinical features and outcomes of patients with both ANCA and anti-GBM antibodies. Kidney Int. 2004. 66:1535. [Ref 3] Pusey CD. Anti-glomerular basement membrane disease. Kidney Int. 2003. 64(4):1535-1550. [Ref 1]

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