Circulating anti-tubular basement membrane antibody in a variety of human renal diseases: detection and significance.

Serum specimens from 99 selected renal patients were examined over a 3-year period by both a hemagglutination technique (HA) and an indirect immunofluorescent (IIF) method for the presence of circulating antibody against tubular basement membrane (TBM). 11 patients were found with anti-TBM antibodies. 6 of them also had antibody against glomerular basement membrane (GBM). The other 5 with anti-TBM antibody alone, had a unique natural history and response to therapy which suggested that the antibody was important in the pathogenesis of their disease. The variation seen in end organ damage may indicate that other factors, possibly genetic, are involved in the pathophysiology.