A case of Goodpasture's syndrome with massive pulmonary hemorrhage

We present a typical case of Goodpasture's syndrome with massive pulmonary hemorrhage and acute deterioration of renal function. A 20-year-old male wa s admitted due to severe azotemia (blood urea nitrogen 214.7 mg/dL, serum c reatinine 30.2 mg/dL) and was treated with emergency hemodialysis. On the 4 th hospital day, a sudden onset of pulmonary hemorrhage developed. The circ ulating level of anti-glomerular basement membrane antibody was then elevat ed highly, and the kidney biopsy showed crescentic glomerulonephritis and l inear deposition of IgG along the glomerular capillary. The patient was tre ated with intravenous high dose-steroid, oral cyclophosphamide and plasma e xchanges. The pulmonary hemorrhage improved with the therapy, however, his renal function did not improve. He is currently on a regular schedule of he modialysis.