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Seronegative Goodpasture’s syndrome associated with organising pneumonia
  1. Ju Young Bae1,
  2. Khalil Ian Hussein2,
  3. Eric Leibert3 and
  4. Herbert M Archer1
  1. 1Internal Medicine, Greenwich Hospital/Yale-New Haven Health, Greenwich, Connecticut, USA
  2. 2Medical Education, Greenwich Hospital/Yale-New Haven Health, Greenwich, Connecticut, USA
  3. 3Pulmonary/Critical Care, Greenwich Hospital/Yale-New Haven Health, Greenwich, Connecticut, USA
  1. Correspondence to Dr Khalil Ian Hussein; khalil.hussein{at}ynhh.org

Abstract

Goodpasture’s syndrome is a rare vasculitis associated with anti-glomerular basement membrane (anti-GBM) autoantibodies that target type IV collagen found in the basement membranes of glomeruli and alveoli. We present a case of a 79-year-old man with seronegative Goodpasture’s syndrome with predominant respiratory symptoms and mild acute kidney injury that initially improved. Final diagnosis was made by immunofluorescent staining on open lung biopsy which also revealed concomitant organising pneumonia. The patient underwent treatment with corticosteroids, cyclophosphamide, haemodialysis and plasmapheresis. This was an atypical presentation wherein the patient only exhibited pulmonary symptoms early in the course of illness in the setting of negative anti-GBM antibody serum testing, which made diagnosis challenging. With this case, we emphasise that clinicians should have a high suspicion for Goodpasture’s syndrome in the setting of unexplained severe pulmonary or renal disease despite negative anti-GBM antibody testing.

  • cardiothoracic surgery
  • vasculitis
  • acute renal failure
  • interstitial lung disease
  • pathology

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Footnotes

  • Contributors JYB was responsible for conception of this work, data collection from patient chart and wrote initial drafts of each section. KIH performed the literature search, data collection from patient chart and authored critical revisions of the article. EL contributed critical revisions of the article and data collection in the form of image selection. HMA contributed critical revisions of the article and gave final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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

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