[Variable presentation of antiglomerular basement membrane (anti-GBM) disease: rapid recognition vitally important].
The classic clinical presentation of anti-GBM disease, or Goodpasture's disease, is pulmonary haemorrhage in combination with rapidly progressive glomerulonephritis. However, presenting symptoms vary considerably. To illustrate this, this article describes 3 male patients with anti-GBM disease, aged 25, 27 and 25 years respectively. The first patient presented with massive haemoptysis without glomerulonephritis, the second patient presented with a microcytic anaemia, caused by subclinical alveolar bleeding, and the third patient presented with rapidly progressive glomerulonephritis in combination with respiratory failure. All 3 patients required mechanical ventilation but did survive. Two patients progressed to end-stage renal disease (ESRD). Earlier recognition might prevent respiratory failure and ESRD. Therefore, despite heterogeneous clinical presentation, immediate recognition of anti-GBM disease is vitally important in view of the potentially lethal consequences if left untreated.
Medisch Centrum Alkmaar, afd. Interne Geneeskunde, Alkmaar, The Netherlands. k.vangalen@vumc.nl
Karin P M
KP
van Galen
Laurien M A
LM
Oswald
Joost G
JG
van den Aardweg
F
F
Stam
José G
JG
van den Berg
Willem A
WA
Bax
D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D011379:Prognosis; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control