title: Pre-existing chronic interstitial pneumonia is a poor prognostic factor of Goodpasture's syndrome: a case report and review of the literature.
abstract: BACKGROUND
  Goodpasture's syndrome is a rare disease that is characterized by rapidly progressive glomerulonephritis and diffuse alveolar hemorrhage.
  
  
  METHODS
  A 71-year-old Japanese man who had chronic interstitial pneumonia was diagnosed as having Goodpasture's syndrome. Both anti-glomerular basement membrane antibody and myeloperoxidase anti-neutrophil cytoplasmic antibody were increased. Despite intensive treatments, including mechanical ventilation, he died from respiratory failure. Pathological findings at autopsy showed rapidly progressive glomerulonephritis in his kidneys, diffuse alveolar hemorrhage, hyaline membranes, and fibroblastic foci in his lungs. The cause of death was diagnosed as respiratory failure as a result of diffuse alveolar damage induced by a combination of diffuse alveolar hemorrhage and exacerbation of interstitial pneumonia.
  
  
  CONCLUSIONS
  We report a case of Goodpasture's syndrome complicated with pre-existing chronic interstitial pneumonia and positive myeloperoxidase anti-neutrophil cytoplasmic antibody. We reviewed six similar cases reported in the literature and concluded that Goodpasture's syndrome with pre-existing interstitial pneumonia and myeloperoxidase anti-neutrophil cytoplasmic antibody is related to a poor prognosis.
authors.affiliation: Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tashiro
authors.affiliation: Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. takahak@cc.saga-u.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Uchiumi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Fukuda
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Miyazono
authors.initials: M
authors.lastname: Motoaki
authors.affiliation: Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kimura
authors.affiliation: Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sueoka-Aragane
mesh_terms: D000368:Aged; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications / Q000473:pathology*; D019268:Antibodies, Antineutrophil Cytoplasmic; D044466:Asian People; D001323:Autoantibodies; D001344:Autopsy; D017809:Fatal Outcome; D005921:Glomerulonephritis / Q000150:complications / Q000473:pathology*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000473:pathology*; D008297:Male; D011014:Pneumonia / Q000473:pathology*; D011379:Prognosis; D012131:Respiratory Insufficiency
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; C051951:antiglomerular basement membrane antibody
keywords: Anti-glomerular basement membrane antibody; Goodpasture’s syndrome; Interstitial pneumonia; Myeloperoxidase anti-neutrophil cytoplasmic antibody