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Vol 11, No 5 (2016)
Case Reports
Published online: 2016-09-15
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Goodpasture’s syndrome as a diagnostic and therapeutic challenge for cardiologist

Anna Chuda, Małgorzata Lelonek
DOI: 10.5603/FC.a2016.0088
·
Folia Cardiologica 2016;11(5):433-439.

open access

Vol 11, No 5 (2016)
Case Reports
Published online: 2016-09-15

Abstract

We describe a case of 67-year-old man, with rapidly progressive crescentic glomerulonephritis in the course of
Goodpasture’s syndrome and acute coronary syndrome (ACS). The disease was initially presented with proteinuria and hematuria on urinalysis and hemoptysis. Immunologic tests for anti-GBM Ab were positive. At the time of diagnosis the patient presented with renal insufficiency with oliguria requiring hemodialysis but without pulmonary hemorrhage. Renal biopsy showed cellular crescents in all glomeruli with linear deposition of IgG along the GBM. Repeated testing showed anti-GBM Ab. The patient received pulse cyclophosphamide, and pulse methylprednisolone continued by oral prednisone, and consecutive plasma exchange treatment. The patient had cardiac complications in the form of coronary events and tachyarrhythmias (atrial fibrillation). Because of the risk of thromboembolism he required anticoagulation, but with such a high risk of bleeding the therapy has not been started. The case confirms that for each patient with atrial fibrillation we need to individually assess the risks and benefits of our treatment and consider new treatments that reduce the embolic risk and minimize bleeding complications.

Abstract

We describe a case of 67-year-old man, with rapidly progressive crescentic glomerulonephritis in the course of
Goodpasture’s syndrome and acute coronary syndrome (ACS). The disease was initially presented with proteinuria and hematuria on urinalysis and hemoptysis. Immunologic tests for anti-GBM Ab were positive. At the time of diagnosis the patient presented with renal insufficiency with oliguria requiring hemodialysis but without pulmonary hemorrhage. Renal biopsy showed cellular crescents in all glomeruli with linear deposition of IgG along the GBM. Repeated testing showed anti-GBM Ab. The patient received pulse cyclophosphamide, and pulse methylprednisolone continued by oral prednisone, and consecutive plasma exchange treatment. The patient had cardiac complications in the form of coronary events and tachyarrhythmias (atrial fibrillation). Because of the risk of thromboembolism he required anticoagulation, but with such a high risk of bleeding the therapy has not been started. The case confirms that for each patient with atrial fibrillation we need to individually assess the risks and benefits of our treatment and consider new treatments that reduce the embolic risk and minimize bleeding complications.

Get Citation

Keywords

pulmonary-renal syndrome, rapidly progressive glomerulonephritis, Goodpasture’s syndrome, atrial fibrillation, coronary events

About this article
Title

Goodpasture’s syndrome as a diagnostic and therapeutic challenge for cardiologist

Journal

Folia Cardiologica

Issue

Vol 11, No 5 (2016)

Pages

433-439

Published online

2016-09-15

DOI

10.5603/FC.a2016.0088

Bibliographic record

Folia Cardiologica 2016;11(5):433-439.

Keywords

pulmonary-renal syndrome
rapidly progressive glomerulonephritis
Goodpasture’s syndrome
atrial fibrillation
coronary events

Authors

Anna Chuda
Małgorzata Lelonek

References (12)
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