Goodpasture syndrome involving overlap with Wegener's granulomatosis and anti-glomerular basement membrane disease

Raghu Kalluri, Kevin Meyers, Andras Mogyorosi, Michael P. Madaio, Eric G. Neilson

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

A 68-year-old Caucasian woman presented to the hospital with nodular pulmonary infiltrates and acute renal failure. Wegener's granulomatosis was initially considered to be most likely because of the presence of increased serum levels of c-anti-neutrophil cytoplasmic antibodies (c-ANCA). A consultation through the Internet after a renal biopsy demonstrated crescentic, necrotizing glomerulonephritis and linear deposits of immunoglobulin G (IgG) and complement C3, typical of anti-glomerular basement membrane (GBM) disease. Hemodialysis was instituted; however, the patient suddenly developed a massive cerebral hemorrhage and died before full therapy could take effect. Postmortem analysis of the patient's sera revealed high titers of IgG against the α3 NC1 domain of type IV collagen. Serologic evidence of both p-ANCA and anti-GBM antibodies are becoming more frequently recognized in the setting of rapidly progressive glomerulonephritis. The patient reported here had the unusual combination of c-ANCA antibodies with anti-GBM disease, and this association raises complex questions regarding the pathogenesis of this type of renal injury.

Original languageEnglish (US)
Pages (from-to)1795-1800
Number of pages6
JournalJournal of the American Society of Nephrology
Volume8
Issue number11
StatePublished - Nov 1 1997
Externally publishedYes

ASJC Scopus subject areas

  • Nephrology

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