---
title: "Intracranial subarachnoid hemorrhage and cerebral infarction in anti-GBM disease: case and review"
id: "pubmed-42581255"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42581255"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42581255/"
doi: "10.1007/s13730-026-01172-9"
published_at: "2026-08-12T00:00:00.000Z"
evidence_level: "Case Reports"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Intracranial subarachnoid hemorrhage and cerebral infarction in anti-GBM disease: case and review
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42581255
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42581255/)
- **DOI:** [10.1007/s13730-026-01172-9](https://doi.org/10.1007%2Fs13730-026-01172-9)
- **Published At:** 2026-08-12T00:00:00.000Z
- **Evidence Rating:** Case Reports
## Executive GIST (TL;DR)
- A 53-year-old woman presented with fever and headache and rapidly developed acute kidney injury with markedly elevated **anti-GBM antibody** titers; renal biopsy confirmed anti-glomerular basement membrane (anti-GBM) disease. - Initial management included **plasma exchange** and high-dose corticosteroids, but renal function worsened and the patient became dialysis-dependent. - **Rituximab** was added after an inadequate response to conventional therapy to achieve serological control. - During the clinical course the patient developed a generalized seizure and was diagnosed with intracranial **subarachnoid hemorrhage (SAH)**, followed by a subacute cerebral infarction. - Cerebral angiography showed no aneurysms or vascular malformations; blood pressure had been stable before the neurological event. - Intensive management continued (plasma exchange, rituximab, corticosteroids) with strict blood pressure control; no neurological sequelae were observed. - Anti-GBM antibody titers gradually declined, but renal function did not recover. - The report highlights that central nervous system involvement, particularly intracranial **SAH**, is exceedingly uncommon in anti-GBM disease and underscores the need for careful neurological monitoring in affected patients. - Details on frequency, pathophysiology, and comparative outcomes from the literature review are not presented in the abstract and would require consultation of the full article and references.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Nephrology, Osaka International Medical & Science Center (Osaka Keisatsu Hospital), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan. koheioka0619@gmail.com. * 2 Department of Nephrology, Osaka International Medical & Science Center (Osaka Keisatsu Hospital), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan. * 3 Department of Immunology, Osaka International Medical & Science Center (Osaka Keisatsu Hospital), Osaka, Japan. * PMID: **42581255** * DOI: [ 10.1007/s13730-026-01172-9 ](https://doi.org/10.1007/s13730-026-01172-9) Item in Clipboard Review # Subarachnoid hemorrhage and cerebral infarction in anti-glomerular basement membrane disease: a case report and literature review Kohei Oka et al. CEN Case Rep. 2026. Show details Display options Display options Format Abstract PubMed PMID CEN Case Rep Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22CEN+Case+Rep%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22CEN+Case+Rep%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) . 2026 Aug 12;15(5):132. doi: 10.1007/s13730-026-01172-9. ### Authors [Kohei Oka](https://pubmed.ncbi.nlm.nih.gov/?term=Oka+K&cauthor_id=42581255)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-1 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan. koheioka0619@gmail.com."), [Takayuki Kawaoka](https://pubmed.ncbi.nlm.nih.gov/?term=Kawaoka+T&cauthor_id=42581255)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-2 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan."), [Rina Oda](https://pubmed.ncbi.nlm.nih.gov/?term=Oda+R&cauthor_id=42581255)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-2 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan."), [Haruna Tanoue](https://pubmed.ncbi.nlm.nih.gov/?term=Tanoue+H&cauthor_id=42581255)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-2 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan."), [Kumie Teramoto](https://pubmed.ncbi.nlm.nih.gov/?term=Teramoto+K&cauthor_id=42581255)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-2 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan."), [Ryoko Tatsumi](https://pubmed.ncbi.nlm.nih.gov/?term=Tatsumi+R&cauthor_id=42581255)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-2 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan."), [Nachi Ishikawa](https://pubmed.ncbi.nlm.nih.gov/?term=Ishikawa+N&cauthor_id=42581255)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-3 "Department of Immunology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), Osaka, Japan."), [Hitoshi Mizuno](https://pubmed.ncbi.nlm.nih.gov/?term=Mizuno+H&cauthor_id=42581255)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42581255/#short-view-affiliation-2 "Department of Nephrology, Osaka International Medical & Science Center \(Osaka Keisatsu Hospital\), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan.") ### Affiliations * 1 Department of Nephrology, Osaka International Medical & Science Center (Osaka Keisatsu Hospital), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan. koheioka0619@gmail.com. * 2 Department of Nephrology, Osaka International Medical & Science Center (Osaka Keisatsu Hospital), 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-0042, Japan. * 3 Department of Immunology, Osaka International Medical & Science Center (Osaka Keisatsu Hospital), Osaka, Japan. * PMID: **42581255** * DOI: [ 10.1007/s13730-026-01172-9 ](https://doi.org/10.1007/s13730-026-01172-9) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Anti-glomerular basement membrane (anti-GBM) disease is a rare autoimmune disorder characterized by rapidly progressive glomerulonephritis, with or without pulmonary hemorrhage. Central nervous system (CNS) involvement is exceedingly uncommon, and intracranial subarachnoid hemorrhage (SAH) has rarely been described in association with anti-GBM disease. We report a rare case of anti-GBM disease complicated by intracranial SAH and subsequent cerebral infarction. A 53-year-old woman presented with fever and headache and rapidly developed acute kidney injury with markedly elevated anti-GBM antibody titers. Renal biopsy confirmed anti-GBM disease. Despite treatment with plasma exchange and high-dose corticosteroids, renal function deteriorated, and the patient became dialysis-dependent. Rituximab was added to achieve serological control after an insufficient response to conventional therapy. During the clinical course, the patient developed a generalized seizure and was diagnosed with intracranial SAH, followed later by a subacute cerebral infarction. Cerebral angiography revealed no aneurysms or vascular malformations. Blood pressure had remained stable prior to the neurological event. Following intensive management, including continued plasma exchange, rituximab, corticosteroids, and strict blood pressure control, no neurological sequelae were observed. Anti-GBM antibody titers gradually declined, although renal function did not recover. This case illustrates a rare occurrence of intracranial subarachnoid hemorrhage as a central nervous system complication in anti-GBM disease and highlights the importance of careful neurological monitoring. **Keywords:** Anti-glomerular basement membrane disease; Central nervous system; Cerebral infarction; Rituximab; Subarachnoid hemorrhage. © 2026. The Author(s), under exclusive licence to Japanese Society of Nephrology. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Conflict of interest: The authors declare that they have no conflicts of interest. Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. ## References 1. 1. McAdoo SP, Pusey CD. Anti-glomerular basement membrane disease. Clin J Am Soc Nephrol. 2017;12:1162–72. - [DOI](https://doi.org/10.2215/cjn.01380217) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/28515156/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/5498345/) 2. 1. Lahmer T, Küchle C, Schirmer L, Heemann U, Lutz J, Thürmel K. Kidney transplant after preexisting posterior reversible encephalopathy syndrome induced by Goodpasture’s syndrome. Exp Clin Transplant. 2012;10:299–301. - [DOI](https://doi.org/10.6002/ect.2011.0177) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/22631071/) 3. 1. Camara-Lemarroy CR, Cruz-Moreno MA, Gamboa-Sarquis RN, Gonzalez-Padilla KA, Tamez-Perez HE, Galarza-Delgado DA. Goodpasture syndrome and posterior reversible encephalopathy syndrome. J Neurol Sci. 2015;354:135–7. - [DOI](https://doi.org/10.1016/j.jns.2015.05.002) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/25982503/) 4. 1. Maël B, Kahaia L, Sylvain G. A posterior reversible encephalopathy syndrome in a young patient with Goodpasture’s disease. Am J Emerg Med. 2025;96:299.e5-7. - [DOI](https://doi.org/10.1016/j.ajem.2025.06.022) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/40518348/) 5. 1. Han C, Cui X, Tan Z, Li Y, Qiao Y. Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: two cases and literature review. Immun Inflamm Dis. 2023;11:e1074. - [DOI](https://doi.org/10.1002/iid3.1074) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/38018581/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/10632087/) Show all 32 references ## Publication types * Case Reports Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Case+Reports%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Case+Reports) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) * Review Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Review%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Review) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) ## MeSH terms * Acute Kidney Injury / etiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Acute+Kidney+Injury%2Fetiology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Acute+Kidney+Injury) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) * Adrenal Cortex Hormones / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adrenal+Cortex+Hormones%2Ftherapeutic+use%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adrenal+Cortex+Hormones) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) * Anti-Glomerular Basement Membrane Disease* / complications Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-Glomerular+Basement+Membrane+Disease%2Fcomplications%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-Glomerular+Basement+Membrane+Disease) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) * Anti-Glomerular Basement Membrane Disease* / diagnosis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-Glomerular+Basement+Membrane+Disease%2Fdiagnosis%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-Glomerular+Basement+Membrane+Disease) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) * Anti-Glomerular Basement Membrane Disease* / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-Glomerular+Basement+Membrane+Disease%2Ftherapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-Glomerular+Basement+Membrane+Disease) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42581255/) * Autoantibodies / blood Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Autoantibodies%2Fblood%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Autoantibodies) *
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