Document Detail

[79-year-old patient with pulmorenal syndrome].
MedLine Citation:
PMID:  20922641     Owner:  NLM     Status:  MEDLINE    
HISTORY AND ADMISSION FINDINGS: A 79-year-old female patient was referred with acute renal failure requiring haemodialysis and haemoptysis. INVESTIGATIONS: Kidney biopsy showed extracapillary proliferative glomerulonephritis with crescents in 7 from 15 glomeruli and sclerosis in the remaining. A computed tomography scan of the chest showed evidence of alveolar haemorrhage. Serologic testing revealed autoantibodies against the glomerular basement membrane (anti-GBM antibodies) and myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA). DIAGNOSIS, TREATMENT AND COURSE: The patient was diagnosed with goodpasture's disease and underwent immunosuppressive therapy including prednisolone, cyclophosphamide pulses and plasmapheresis, resulting in clearance of anti-GBM antibodies and discontinuation of haemoptysis. Renal function, however, did not recover and the patient remained on dialysis. CONCLUSIONS: Aggressive treatment including cyclophosphamide and plasma separation often ensures patient survival in goodpasture's disease, in most cases, however, renal function does not recover.
Ferruh Artunc; Christiane Dorn; Frank Gehlen; Maike Büttner; Kerstin Amann; Peter Weyrich; Nils Heyne; Sabine Wolf
Publication Detail:
Type:  Case Reports; English Abstract; Journal Article     Date:  2010-10-04
Journal Detail:
Title:  Deutsche medizinische Wochenschrift (1946)     Volume:  135     ISSN:  1439-4413     ISO Abbreviation:  Dtsch. Med. Wochenschr.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2010-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006723     Medline TA:  Dtsch Med Wochenschr     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  1982     Citation Subset:  IM    
Medizinische Klinik, Universitätsklinikum Tübingen, Tübingen, Germany.
Vernacular Title:
Pulmorenales Syndrom bei einer 79-jährigen Patientin.
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MeSH Terms
Anti-Glomerular Basement Membrane Disease / diagnosis*,  immunology,  pathology,  therapy
Antibodies, Antineutrophil Cytoplasmic / blood
Autoantibodies / blood
Combined Modality Therapy
Cyclophosphamide / therapeutic use
Hemoptysis / etiology*,  pathology
Immunoglobulin G / analysis
Immunosuppressive Agents / therapeutic use
Kidney / pathology
Kidney Failure, Acute / etiology*,  pathology
Microscopy, Fluorescence
Peroxidase / immunology
Prednisolone / therapeutic use
Tomography, X-Ray Computed
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Autoantibodies; 0/Immunoglobulin G; 0/Immunosuppressive Agents; 0/antiglomerular basement membrane antibody; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; EC

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