GOODPASTURES-LIKE SYNDROME AND EFFECT OF EXTRACORPOREAL MEMBRANE-OXYGENATOR SUPPORT

A 49-year-old man was admitted because of general fatigue, cough and h ematuria. During the hospital course, acute renal failure, hemoptysis and dyspnea developed. A percutaneous renal biopsy revealed a diffuse crescentic glomerulonephritis, and direct immunofluorescence showed a linear pattern of IgG along the glomerular basement membrane. Although serum anti-glomerular basement membrane (anti-GBM) antibody was not d etected, Goodpasture's-like syndrome was suspected, and methylpredniso lone pulse therapy and plasmapheresis were administered. Concomitantly , extracorporeal membrane oxygenation (ECMO) was instituted because of deterioration in respiratory status due to a severe pulmonary hemorrh age despite maximal ventilatory support. Temporarily, the patient impr oved and ECMO was discontinued. ECMO may be a useful therapeutic suppo rt for hypoxia resulting from pulmonary hemorrhage in Goodpasture's sy ndrome (GPS) and Goodpasture's-like syndrome.