title: An 80-year-old female with double positive disease: Case report and brief review of literature.
abstract: BACKGROUND
  Goodpasture's syndrome is a triad of alveolar hemorrhage, Glomerulonephritis and circulating anti Glomerular basement membrane antibodies, 25% of cases test positive for ANCA antibodies, this association is known as Double positive disease. This article describes a rare presentation of this entity and reviews available literature.
  
  
  METHODS
  80 year old female presented with hemoptysis and renal failure, she tested positive for both p ANCA and anti glomerular basement membrane antibodies, and despite aggressive medical treatment, she suffered a frustrating outcome.
  
  
  CONCLUSIONS
  Double positive disease accounts for 25% of cases of Goodpasture's syndrome, a suggested Pathophysiology of this association is the renal involvement in ANCA Vasculitis leading to the exposure of antigens from the basement membrane and the formation of antibodies. This entity is believed to carry better prognosis when compared to isolated anti glomerular basement membrane disease.
authors.affiliation: Department of Medicine, John H Stroger Hospital of Cook County, Chicago, IL, U.S.A.
authors.forename: Tarek
authors.initials: T
authors.lastname: Almouradi
authors.forename: Peter
authors.initials: P
authors.lastname: Hart
authors.forename: Talia
authors.initials: T
authors.lastname: Muram-Zborovski
keywords: double positive disease; goodpasture syndrome; p-ANCA; pulmonary renal syndrome