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Tuesday, May 3, 2011

CLINICAL CASE 36, ANSWERS AND SUMMARY

Which of the following regarding Anti GBM disease in elderly is true?

This entity is non existent in the age> 65   0%
Anti GBM disease in the elderly is more of a female predominance
15% 
Anti GBM disease in the elderly is more severe than in the younger patients
17%
Anti GBM disease has more severe lung hemorrhage than younger patients
10%
Anti GBM disease has a significantly higher proportion of positive ANCA results in this age group
57%

Good work all. Majority got this one right. Recently in AJKD this topic was reviewed looking especially at cases in the elderly.  This entity does exist in the elderly and fairly common. It has more of a male predominance and it is actually LESS severe than when it happens in younger patients.  The lung disease is also LESS severe. The correct answer hence is the last one- it does occur a lot of time concurrently with a positive ANCA blood test in this age group. This group also has lower proteinuria at presentation and higher GFR on presentation. 

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