Case Report of a Patient with Goodpasture's Syndrome Who Relapsed While on Hemodialysis

Abstract

Goodpasture's syndrome is a rare autoimmune disease in which anti-glomerular basement membrane antibodies damage the glomerular and alveolar basement membrane. Its relapse is very rare, compared to other pulmonary-renal syndromes. Herein, we present an unusual case of Goodpasture's syndrome, which recurred despite immunosuppressive treatment. After the initial treatment with corticosteroid and cyclophosphamide pulses, plasmapheresis, alveolar hemorrhage ended, and the anti-glomerular basement membrane antibody finding became negative, but hemodialysis had to be continued. After 8 months of hemodialysis, anti-glomerular basement membrane antibodies were re-detected, and hemoptysis occurred a month later. Then, plasmapheresis, intravenous immunoglobulin, and methylprednisone were given in addition to azathioprine treatment; however, the serum anti-glomerular basement membrane antibody positivity persisted.