Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage
Goodpasture syndrome is a rare autoimmune disease comprising antiglomerular basement membrane (anti-GBM) crescentic glomerulonephritis and pulmonary capillaritis with circulating anti-GBM antibodies. Rarely, antibody-negative cases have been described. We report a young, African American adult woman...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/2975131 |
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| author | Charlene L. Rohm Sara Acree Aseem Shrivastava Asif A. Saberi Louis Lovett |
| author_facet | Charlene L. Rohm Sara Acree Aseem Shrivastava Asif A. Saberi Louis Lovett |
| author_sort | Charlene L. Rohm |
| collection | DOAJ |
| description | Goodpasture syndrome is a rare autoimmune disease comprising antiglomerular basement membrane (anti-GBM) crescentic glomerulonephritis and pulmonary capillaritis with circulating anti-GBM antibodies. Rarely, antibody-negative cases have been described. We report a young, African American adult woman admitted with flank pain and hematuria with laboratory testing and kidney biopsy demonstrating anti-GBM crescentic glomerulonephritis with elevated anti-GBM antibody levels. She received treatment but remained dialysis-dependent. She was seronegative and clinically stable until she presented 8 months later with dyspnea and hemoptysis requiring mechanical ventilation. Bronchoscopy revealed diffuse alveolar hemorrhage. She was treated for relapse of Goodpasture syndrome. However, anti-GBM antibodies were undetectable. This case emphasizes prompt diagnosis and treatment of Goodpasture syndrome to preserve renal function. Additionally, clinical manifestations of Goodpasture syndrome and its degree of activity do not necessarily correlate with the actual antibody titer on relapse. Clinicians should have enhanced awareness of this atypical presentation of a rare disease. |
| format | Article |
| id | doaj-art-cba6503ed35446d288c92a4bf1abdf94 |
| institution | DOAJ |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-cba6503ed35446d288c92a4bf1abdf942025-08-20T03:23:38ZengWileyCase Reports in Medicine1687-96271687-96352019-01-01201910.1155/2019/29751312975131Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary HemorrhageCharlene L. Rohm0Sara Acree1Aseem Shrivastava2Asif A. Saberi3Louis Lovett4Department of Internal Medicine, WellStar Kennestone Regional Medical Center, Marietta, GA, USADepartment of Pathology, WellStar Kennestone Regional Medical Center, Marietta, GA, USACritical Care Medicine, WellStar Kennestone Regional Medical Center, Marietta, GA, USACritical Care Medicine, WellStar Kennestone Regional Medical Center, Marietta, GA, USADepartment of Graduate Medical Education, WellStar Kennestone Regional Medical Center, Marietta, GA, USAGoodpasture syndrome is a rare autoimmune disease comprising antiglomerular basement membrane (anti-GBM) crescentic glomerulonephritis and pulmonary capillaritis with circulating anti-GBM antibodies. Rarely, antibody-negative cases have been described. We report a young, African American adult woman admitted with flank pain and hematuria with laboratory testing and kidney biopsy demonstrating anti-GBM crescentic glomerulonephritis with elevated anti-GBM antibody levels. She received treatment but remained dialysis-dependent. She was seronegative and clinically stable until she presented 8 months later with dyspnea and hemoptysis requiring mechanical ventilation. Bronchoscopy revealed diffuse alveolar hemorrhage. She was treated for relapse of Goodpasture syndrome. However, anti-GBM antibodies were undetectable. This case emphasizes prompt diagnosis and treatment of Goodpasture syndrome to preserve renal function. Additionally, clinical manifestations of Goodpasture syndrome and its degree of activity do not necessarily correlate with the actual antibody titer on relapse. Clinicians should have enhanced awareness of this atypical presentation of a rare disease.http://dx.doi.org/10.1155/2019/2975131 |
| spellingShingle | Charlene L. Rohm Sara Acree Aseem Shrivastava Asif A. Saberi Louis Lovett Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage Case Reports in Medicine |
| title | Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage |
| title_full | Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage |
| title_fullStr | Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage |
| title_full_unstemmed | Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage |
| title_short | Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage |
| title_sort | antibody negative relapse of goodpasture syndrome with pulmonary hemorrhage |
| url | http://dx.doi.org/10.1155/2019/2975131 |
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