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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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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: Medicine
Publisher: BMJ Publishing Group Ltd
ISSN: 1757-790X
Date of Acceptance: 2 March 2017
Last Modified: 23 May 2018 13:18

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