doiSerbia

Goodpasture's syndrome: Case report

Vučković Biljana (Institut za laboratorijsku medicinu, Klinički centar, Novi Sad)
Ilić Tatjana (Institut za interne bolesti, Klinika za nefrologiju i kliničku imunologiju, Klinički centar, Novi Sad)
Mitić Igor (Institut za interne bolesti, Klinika za nefrologiju i kliničku imunologiju, Klinički centar, Novi Sad)
Knežević Violeta (Institut za interne bolesti, Klinika za nefrologiju i kliničku imunologiju, Klinički centar, Novi Sad)
Vodopivec Slavenka (Institut za interne bolesti, Klinika za nefrologiju i kliničku imunologiju, Klinički centar, Novi Sad)
Čurić Slobodan (Institut za interne bolesti, Klinika za nefrologiju i kliničku imunologiju, Klinički centar, Novi Sad)

Introduction Goodpasture's syndrome is a rare, autoimmune disease characterized by pulmonary hemorrhage, glomerulonephritis and production of anti-GBM (glomerular basement membrane) antibodies. The etiology of this syndrome is still unknown. Goodpasture's syndrome usually starts with pulmonary hemorrhage, which is followed by symptoms of kidney disease. Laboratory findings often include: anemia, microhematuria, proteinuria, increased levels of urea and creatinine and anti-GBM antibodies. Diagnosis of this syndrome can be established by presence of pulmonary hemorrhage, pulmonary radiography, kidney biopsy and positive result of circulating anti-GBM antibodies. Treatment of this syndrome should be initiated as soon as possible using a combination of cortocosteroids, cytostatics and plasmapheresis. Case report The first symptoms in a nineteen-year-old female patient were caused by anemia. Two months later she reported symptoms of pulmonary hemorrhage. At that point of time she already had renal insufficiency and was immediately hospitalized. The same day we started therapy with cortocosteroids, endoxan and plasmapheresis was initiated. Recovery of pulmonary function was obtained, but kidney function was lost. Discussion and Conclusions The most important thing in regard to Goodpasture's syndrome is quick diagnosis. Because of that, if patients report any kind of pulmonary hemorrhage, this syndrome must be considered. At that point of time, kidney function is usually not irreversibly damaged. The second important thing in Goodpasture's syndrome is that treatment must be very aggressive using a combination of immunosuppressives and plasmapheresis. This is the only chance for these patients to avoid hemodialysis or death.

Keywords: goodpasture syndrome, diagnosis, therapy, autoimmune diseases, glomerulonephritis, kidney failure