LOST KIDNEY IN GOODPASTURE SYNDROM-CASE REPORT
Introduction: Goodpasture syndrome is a rare autoimmune syndrome with alveolar hemorrhages and glomerulonephritis caused by circulating antibodies against the glomerular-basement-membrane. Anti-glomerular-basement-membrane were administered against a non-collagen (NC-1) α3 chain of collagen type IV, which was found at the highest concentration in the basal membrane of renal and pulmonary capillaries. The aim of case report is a clinical overview of this rare and severe syndrome.
Case report: The patient, 22-years-old was sent to Center of Urgent Medicine of Clinical Center Kragujevac from General Hospital of Paraćin because of blood poisoning, fever, symptoms and signs of renal and respiratory weakness, and suspected of Wegener's disease. Antibodies were taken on the basement membrane of the glomerulus were resulted of enormously high. After due to the clinical and immunology diagnosis of Goodpasture syndrome, plasmapheresis treatment was initiated. The standard hemodialysis was continued. Following the guidelines protocols, patient received pulse dozes of cytostatics, corticosteroids, etc.
Conclusion: The case report of our patient points to the necessity of multidisciplinary approach of the expert team, consisting of a nephrologist, pulmologist, clinical pharmacologist and other specialists. The prognosis is good, if treatment is started before irreversible pulmonary and/or renal changes (respiratory and/or renal insufficiency). Goodpasture syndrome often progresses rapidly, so it can be fatal if it's delayed with the diagnosis and the treatment. Patients with Goodpasture`s syndrome require an adequate the socio-medical care as a rare and severe syndrome.
Nasrullah A, Fatima Z, Javed A, Tariq U, Saleem MS. A case of anti-glomerular basement disease without pulmonary involvement. Cureus. 2019; 11(2):e4130.
DeVrieze BW, Hurley JA. Goodpasture Syndrome (Anti-glomerular Basement Membrane Antibody Disease) [Updated 2020 Mar 25]. In: StatPearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459291/
Kheiri B, Osman M, Elounais F, Alnimer Y, Owda AK, Modawi I, et al. A case report of double negative anti-GBM disease. Oxf Med Case Reports. 2019; (4):omy124.
Kussman A, Gohara A. Serum antibody-negative Goodpasture syndrome with delta granule pool storage deficiency and eosinophilia. Clin Kidney J. 2012; 5(6):572-5.
Fernandes R, Freitas S, Cunha P, Alves G, Cotter J. Goodpasture's syndrome with absence of circulating anti-glomerular basement membrane antibodies: a case report. J Med Case Rep. 2016; 10:205.
Dammacco F, Battaglia S, Gesualdo L, Racanelli V. Goodpasture's disease: a report of ten cases and a review of the literature. Autoimmun Rev. 2013; 12(11):1101-8.
Mannemuddhu SS, Clapp W, Modica R, Elder ME, Upadhyay K. End-stage renal disease secondary to anti-glomerular basement membrane disease in a child with common variable immunodeficiency. Clin Nephrol Case Stud. 2019; 7:1-6.
Kluger N. Cutaneous vasculitis preceding the onset of anti-GBM disease (Goodpasture syndrome). Presse Med. 2019; 48(Pt 1):79-80.
McAdoo SP, Pusey CD. Antiglomerular basement membrane disease. Semin Respir Crit Care Med. 2018; 39(4):494-503.
Liang D, Liang S, Xu F, Zhang M, Li X, Tu Y,et al. Clinicopathological features and outcome of antibody-negative anti-glomerular basement membrane disease. J Clin Pathol. 2019; 72(1):31-7.
Talash V, Bevzenko T, Yarmola T, Tkachenko L, Pustovoyt H. Goodpascher's syndrome – the challenges in a timely diagnosis and treatment in medical practice (clinical case). Georgian Med News. 2018; 278:107-14.
Lommatzsch C, Lommatzsch A, Heinz C, Heiligenhaus A. Goodpasture syndrome: ocular manifestation in a young man. Ophthalmologe. 2018; 115(9):761-4.
Lübbecke F. Particularities of Goodpasture Syndrome. Dtsch Arztebl Int. 2017; 114(39):662.
Henderson SR, Salama AD. Diagnostic and management challenges in Goodpasture's (anti-glomerular basement membrane) disease. Nephrol Dial Transplant. 2018; 33(2):196-202.
Tashiro H, Takahashi K, Ikeda Y, Uchiumi S, Fukuda M, Motoaki M, et al. Pre-existing chronic interstitial pneumonia is a poor prognostic factor of Goodpasture's syndrome: a case report and review of the literature. J Med Case Rep. 2017; 11(1):102.
- There are currently no refbacks.
Copyright (c) 2020 Zoran Kovacevic, Katarina Janicijevic, Mirjana Janicijevic Petrovic
This work is licensed under a Creative Commons Attribution 4.0 International License.