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Abstract

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Article in Japanese

Case Report

A case of Goodpasture's syndrome with a rapidly worsening alveolar hemorrhage after steroid pulse therapy

Hayami Tsuzukia  Keitaro Sakakibaraa  Kiyoshi Takenakaa  Hiroki Hayashib  Kazue Fujitab  Akihiko Gemmab 

aDepartment of Pulmonary Medicine, Hakujikai Memorial Hospital
bDepartment of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School

ABSTRACT

Goodpasture's syndrome (GPS) is managed by a combination of steroids, cyclophosphamide, and plasmapheresis, but the optimal therapy for mild cases is uncertain. A 45-year-old woman who had a 3-month history of cough and hemosputum visited our hospital. Chest CT revealed slight bilateral ground-glass opacity. In biochemistry views, anti-GBM antibodies were positive, and uric blood was also. Therefore the patient was diagnosed with GPS. On the first hospital day, bronchoscopy was performed to confirm alveolar hemorrhage, and steroid pulse therapy was then done. On the third hospital day, the patient developed respiratory failure as a result of a rapidly worsening alveolar hemorrhage. Administration of cyclophosphamide and plasmapheresis on steroid therapy induced remission. Our case suggested the importance of plasmapheresis combined with steroids and cyclophosphamide for the treatment of mild cases of GPS.

KEYWORDS

Anti-glomerular basement membrane antibody disease  Goodpasture's syndrome  Alveolar hemorrhage  Anti-glomerular-basement membrane antibodies  Plasmapheresis 

Received 13 Dec 2016 / Accepted 13 Jun 2017

AJRS, 6(5): 378-382, 2017

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