Anti-glomerular basement membrane nephritis after extracorporeal shock wave lithotripsy

Rapidly progressive glomerulonephritis was observed in a 37-year-old woman following the administration of extracorporeal shock wave lithotripsy (ESWL ) for a single stone in her right kidney. The renal biopsy specimen showed diffuse cellular crescents in all glomeruli, with linear deposits of immuno globulin G and complement component C-3 along the glomerular basement membr ane (GBM). Circulating anti-GEM antibodies were detected by enzyme-linked i mmunosorbent assay. Thus, the patient was diagnosed with anti-GEM nephritis . It is suggested that ESWL produced an alteration in the GEM leading to th e production of anti-GEM antibodies.