Goodpasture's disease with late presentation of renal abnormality and anti-GBM autoantibody

Boardman, Emily, Sohail, S. and Yadavilli, R. 2017. Goodpasture's disease with late presentation of renal abnormality and anti-GBM autoantibody. BMJ Case Reports 10.1136/bcr-2016-218705

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Abstract

Goodpasture's disease without circulating autoantibodies is a rare presentation of a rare diagnosis. We present the case of a man aged 17 years who had 3 hospital admissions over a 2-month period with haemoptysis and shortness of breath. Throughout his first 2 admissions, his renal function was normal and anti-glomerular basement membrane (GBM) antibodies were negative. CT pulmonary angiogram during his second admission revealed florid and diffuse alveolar infiltrates. However, high-resolution CT chest performed 4 weeks later showed complete resolution of these changes. On his third admission, he developed acute kidney injury. A repeat CT chest revealed the reappearance of initial findings and anti-GBM antibodies were now positive. Goodpasture's disease was subsequently confirmed with renal biopsy. Our case, with delayed onset of renal impairment, initial seronegativity for anti-GBM antibodies and relapsing and remitting CT findings, emphasises the need to consider this diagnosis in the setting of otherwise unexplained pulmonary haemorrhage.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Publisher:	BMJ Publishing Group Ltd
ISSN:	1757-790X
Date of Acceptance:	2 March 2017
Last Modified:	23 May 2018 13:18
URI:	https://orca.cardiff.ac.uk/id/eprint/101796

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