Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 9 3 2020 07 01 Rapid progressive anti-GBM glomerulonephritis with multiple auto-antibodies e30 e30 10.34172/jnp.2020.30 EN David Micarelli https://orcid.org/0000-0001-5096-9440 Teresa Valentina Ranalli https://orcid.org/0000-0002-3625-5596 Anna Rita Taddei https://orcid.org/0000-0001-6063-9939 Angela Solazzo https://orcid.org/0000-0002-2522-468X Francesca Moccia https://orcid.org/0000-0001-6746-3411 Sandro Feriozzi https://orcid.org/0000-0001-8420-8447 Journal Article 10.34172/jnp.2020.30 2020 02 02 2020 03 01 Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by progressive loss of renal function in a short period. At renal biopsy, it is characterized by crescent formation. RPGN may be associated with the presence of circulating antibodies. We report a case of type IV RPGN [ANCA and Anti–glomerular basement membrane (anti-GBM) antibody disease], a severe disease causing a difficult to treat picture. Our case was complicated by severe thrombocytopenia due to the use of heparin and later on by thrombotic microangiopathy. These events occurred rapidly, making the clinical framing and management decisions very hard.