title: Goodpasture's syndrome with concomitant immune complex mixed membranous and proliferative glomerulonephritis.
abstract: Classical Goodpasture's (GP) syndrome is a monophasic illness characterized by pulmonary hemorrhage and rapidly progressive glomerulonephritis with linear IgG deposition along the glomerular and distal tubular basement membrane and estructive necrotizing diffuse extracapillary crescentic glomerulonephritis. The majority of patients have circulating anti-glomerular basement membrane (GBM) antibodies, detectable with standard anti-GBM ELISA. Concurrence of GP syndrome with proliferative glomerulonephritis has only rarely been described. In this report, for the first time we describe in a 21-year-old woman GP syndrome with 50% crescentic sclerosing glomerulonephritis with linear immunofluorescence characteristic of anti-GBM pathogenesis, combined with mixed membranous and membranoproliferative glomerulonephritis with granular immunofluorescence and subepithelial, mesangial and subendothelial deposits characterizing immune complex pathogenesis. The clinical picture was also unusual for GP syndrome, manifesting a recurrent but non-progressive course, nephrotic syndrome, normal renal function and low values of anti-GBM antibodies, identified only by novel more sensitive techniques.
authors: Vesna
authors: V
authors: Jurcić
authors: Alenka
authors: A
authors: Vizjak
authors: Andreja Aleš
authors: AA
authors: Rigler
authors: Jera
authors: J
authors: Jeruc
authors: Jörgen
authors: J
authors: Wieslander
authors: Dušan
authors: D
authors: Ferluga
mesh_terms: D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D005455:Fluorescent Antibody Technique; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007105:Immune Complex Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; C051951:antiglomerular basement membrane antibody