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BMJ Case Reports 2017; doi:10.1136/bcr-2016-218705
  • CASE REPORT

Goodpasture's disease with late presentation of renal abnormality and anti-GBM autoantibody

  1. Rajesh Yadavilli2
  1. 1Cardiff University, Cardiff, South Glamorgan, UK
  2. 2Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
  1. Correspondence to Dr Emily Ann Boardman, emily.boardman{at}doctors.org.uk
  • Accepted 2 March 2017
  • Published 17 March 2017

Summary

Goodpasture's disease without circulating autoantibodies is a rare presentation of a rare diagnosis. We present the case of a man aged 17 years who had 3 hospital admissions over a 2-month period with haemoptysis and shortness of breath. Throughout his first 2 admissions, his renal function was normal and anti-glomerular basement membrane (GBM) antibodies were negative. CT pulmonary angiogram during his second admission revealed florid and diffuse alveolar infiltrates. However, high-resolution CT chest performed 4 weeks later showed complete resolution of these changes. On his third admission, he developed acute kidney injury. A repeat CT chest revealed the reappearance of initial findings and anti-GBM antibodies were now positive. Goodpasture's disease was subsequently confirmed with renal biopsy. Our case, with delayed onset of renal impairment, initial seronegativity for anti-GBM antibodies and relapsing and remitting CT findings, emphasises the need to consider this diagnosis in the setting of otherwise unexplained pulmonary haemorrhage.

Footnotes

  • Contributors EAB identified and managed the case, performed a literature search and drafted and revised the report. She is the guarantor. SS identified the case, did the literature search and drafted and revised the report. RY revised the report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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