title: Pulmonary hemorrhage complicating Goodpasture's disease in the course of pulmonary tuberculosis.
abstract: A 72-year-old man with ESRD on hemodialysis was referred to the hospital because of hemoptysis. A chest radiograph showed diffuse infiltration in the right lung field. Laboratory data showed hematuria and proteinuria. A kidney biopsy revealed diffuse crescentic glomerulonephritis with linear staining of IgG along the glomerular basement membrane (GBM). However, circulating IgG anti-GBM antibodies were not detected. Because the findings of renal biopsy suggested Goodpasture's disease, the patient was treated with plasmapheresis and pulse steroid therapy, which resulted in a rapid resolution of his pulmonary symptoms and chest radiograph abnormalities. However, sputum culture on admission yielded Mycobacterium tuberculosis 3 weeks later. Therefore, immuosuppressive agents were discontinued and antituberculous agents were administered. There was no relapse of pulmonary hemorrhage during the next 1-year period of follow-up, but the patient did not regain renal function and remained on hemodialysis.
authors: Division of Nephrology, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 500, Taiwan.
authors: Yao-Ko
authors: YK
authors: Wen
authors: Kai-I
authors: KI
authors: Wen
mesh_terms: D000368:Aged; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications* / Q000628:therapy; D000995:Antitubercular Agents / Q000627:therapeutic use; D006469:Hemoptysis / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D010956:Plasmapheresis; D006435:Renal Dialysis; D013256:Steroids / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D013256:Steroids