[Goodpasture syndrome--diagnostic problems].
This article describes a case of a 44-year-old male patient, with history, of tuberculosis who was admitted to the hospital with high temperature, coughing, haemoptysis, arterial hypertension and end-stage renal failure. In the differential diagnosis of haemoptysis we took into account pneumonia, exacerbation of tuberculosis, pulmonary neoplasm and Goodpasture syndrome. Presence of antibodies against the glomerular basement membrane (GBM) and histopathologic examination of biopsy specimen confirmed the diagnosis of Goodpasture syndrome. Due to advanced renal failure haemodialysis therapy was introduced. Pharmacological treatment, apart from antibiotics, diuretics and hypotension drugs, included prednisone and cyclophosphamide. Despite immunosuppressive treatment, we did not observe the return of kidney function and thus the patient was enrolled for permanent haemodialysis therapy. We observed a permanent absence of antibodies to GBM in the circulation. In the course of 6 years' treatment, the patient's condition is described as very good with no recurrence of haemoptysis. On June 30th 2003 renal transplantation was performed.
Sydor
Antoni
A
I Oddział Chorób Wewnetrznych i Nefrologii, z Ośrodkiem Dializ Szpitala Wojewódzkiego, im. św. Lukasza w Tarnowie.
Siudzińska
Joanna
J
Dubiel-Bigaj
Maria
M
Plezia
Bogusław
B
Okoń
Krzysztof
K
D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000175:diagnosis* / Q000628:therapy*; D000906:Antibodies / Q000097:blood; D001485:Basement Membrane / Q000276:immunology; D003937:Diagnosis, Differential; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D016030:Kidney Transplantation; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D006435:Renal Dialysis; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis
D000906:Antibodies