Goodpasture Syndrome: Case Report

Abstract

The Goodpasture syndrome is an immune-inflammatory pathology characterized by the formation of autoantibodies directed against the basement membranes of the renal glomeruli and pulmonary alveoli, manifested by hemorrhagic pneumonitis in combination with pulmonary hemorrhage (hemoptysis) and glomerulonephritis. To date, etiological mechanisms of the disease are unknown. Clinical observations indicate a relationship between the development of Goodpasture syndrome and viral infection, intake of medications, industrial hazards. The incidence of Goodpasture syndrome is estimated to be 1 case per 1 million population. Due to the rarity of this pathology, each case of Goodpasture syndrome is of great theoretical and practical interest. The authors conducted the analysis of clinical and morphological observation of Goodpasture syndrome. The postmortem study revealed morphological signs indicating the presence of Goodpasture syndrome inter vivos, whose main manifestations were hemorrhagic pneumonitis and mesangial-proliferative glomerulonephritis with fibroplastic transformation. The reported case is also of particular interest in terms of correct formulation of the final diagnosis, since there was a combination of two diseases: Goodpasture syndrome and phlegmonous appendicitis with focal peritonitis. In this case, pulmonary heart failure should be considered as the direct cause of death, since pulmonary lesions prevailed over the renal ones, which is fully consistent with the clinical presentation and findings of the laboratory tests. The diagnosis of Goodpasture syndrome made at the hospital is not always timely, as can be evidenced by patient’s severe condition, and it requires careful differentiation with a number of other diseases involving hemorrhagic pulmonary and renal syndrome, and the urgent need for active therapy with immunosuppressants, including prednisone and cytostatics. The timely adequate treatment significantly improves the prognosis.