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

Özet

Goodpasture’s syndrome is a rare autoimmune disease in which anti-glomerular basement membrane antibodies damagethe 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. Afterthe initial treatment with corticosteroid and cyclophosphamide pulses, plasmapheresis, alveolar hemorrhage ended, andthe anti-glomerular basement membrane antibody finding became negative, but hemodialysis had to be continued. After8 months of hemodialysis, anti-glomerular basement membrane antibodies were re-detected, and hemoptysis occurred amonth later. Then, plasmapheresis, intravenous immunoglobulin, and methylprednisone were given in addition to azathioprine treatment; however, the serum anti-glomerular basement membrane antibody positivity persisted.Relapse of this syndrome is rare, and if observed, it generally strikes years following disappearance of anti-glomerularbasement membrane antibodies; however, in our case, relapse was observed within a few months. It should be kept inmind that, in patients who achieve remission following immunosuppressive therapy, clinical and serological relapses arerare, and the anti-glomerular basement membrane antibody positivity may persist despite the application of immunosuppressive agents in subjects who relapsed.