Goodpasture's disease, an alternative diagnosis
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Abstract
Introduction: Goodpasture's disease is an autoimmune disease mediated by anti-glomerular basement membrane (GBM) antibodies. It primarily affects the kidneys and/or lungs. It is rare and can be severe and even fatal if not diagnosed early.
Case presentation: A patient with febrile syndrome associated with a dry cough and asthenia received outpatient antibiotic therapy without improvement. Multiple chest CT scans revealed migratory nodular images and a negative rheumatologic profile. Bronchoalveolar lavage revealed no germ development, and percutaneous puncture and video-assisted thoracoscopic biopsy revealed an inflammatory pattern in the sample, without atypia. The patient developed hemoptysis. Anti-glomerular basement membrane antibodies were requested, which were positive, interpreting the condition as Goodpasture's disease.
Discussion: Goodpasture's disease is a rare entity. Anti-GBM antibodies can affect both the kidneys, causing rapidly progressive glomerulonephritis, and the lungs, primarily causing alveolar hemorrhage. Between 60% and 80% of patients have clinically evident manifestations of lung/kidney disease, and less than 10% have disease limited to the lungs.
Conclusion: Goodpasture's disease, which affects only the lungs, is a rare entity and can mimic other pathologies and become a challenge. Because it is relatively uncommon, the time to diagnosis is longer, leading to a delay in targeted treatment.
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