Respir Case Rep. 2015; 4(2): 96-100 | DOI: 10.5505/respircase.2015.55706

A Rare Cause of Hemoptysis: Goodpasture Syndrome

Mehmet Ünlü, Pýnar Çimen, Ýsmail Kayaalp, Nuran Katgý, Salih Zeki Güçlü
Department of Pulmonology, Dr. Suat Seren Training and Research Hospital for Thoracic Medicine and Surgery, Ýzmir, Turkey

Goodpasture syndrome is a rare, autoimmune disease characterized by diffuse pulmonary hemorrhage (DAH), glomerulonephritis, and the production of anti-glomerular basement membrane antibodies. A 20-year-old male presented to the emergency department of our hospital with progressive dyspnea and intermittent hemoptysis over the last four months. His posteroanterior chest radiograph demonstrated reticulonodular opacities throughout the both lungs and alveolar hemorrhage was the dominant pathologic finding of the transbronchial biopsies. The urinalysis revealed microscopic hematuria and micro-albuminuria, and the percutaneous kidney biopsy demonstrated crescentic glomerulonephritis. Anti-glomerular basement membrane antibodies were detected in the circulation and the patient was diagnosed with Goodpasture syndrome. This syndrome usually starts with DAH, which is followed by symptoms of kidney disease and may result in chronic kidney failure. Physicians should always keep this syndrome in mind, especially in young adults presenting with DAH; treatment of this syndrome should be initiated as soon as possible.

Keywords: Diffuse alveolar hemorrhage, Goodpasture syndrome, crescentic glomerulonephritis.

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Nadir Bir Hemoptizi Nedeni: Goodpasture Sendromu

Mehmet Ünlü, Pýnar Çimen, Ýsmail Kayaalp, Nuran Katgý, Salih Zeki Güçlü
Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Bilim Dalý, Ýzmir

Goodpasture Sendromu nadir görülen ve otoimmün kökenli bir hastalýk olup diffüz alveoler hemoraji (DAH), glomerülonefrit ve anti-glomerüler bazal membran antikorlarýnýn üretimi ile karakterizedir. Yirmi yaþýnda erkek hasta hastanemizin acil servisine dört aydan beri artýþ gösteren nefes darlýðý ve tekrarlayan hemoptizi yakýnmalarý ile baþvurdu. Hastanýn posteroanterior akciðer grafisinde her iki akciðerin tüm zonlarýnda retikülonodüler opasite artýþý ve transbronþial akciðer biyopsisinde alveoler hemoraji ile uyumlu bulgular saptandý. Ýdrar analizinde hematüri ve mikroalbüminüri tespit edilen hastanýn, böbrek biyopsisi sonucu da kresentik glomerülonefrit olarak raporlandý. Dolaþýmda antiglomerül bazal membran antikorlarýnýn varlýðý tespit edildi ve hastaya Goodpasture Sendromu tanýsý konuldu. Goodpasture Sendromunda ilk baþvuru genellikle DAH þeklinde olmakla birlikte, kronik böbrek yetmezliðine neden olabilecek böbrek tutulumu da geliþebilmektedir. Özellikle genç eriþkinlerde DAH ile baþvuran hastalarda bu taný akla getirilmeli ve uygun tedavi en kýsa süre içerisinde baþlanmalýdýr.

Anahtar Kelimeler: Diffüz alveoler hemoraji, Goodpasture sendromu, kresentik glomerülonefrit.

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