Goodpasture's syndrome with massive pulmonary haemorrhage in the absence of circulating anti-GBM antibodies?

Abstract

Clinical manifestation of Goodpasture’s syndrome is usually characterized by the combination of glomerulonephritis and diffuse alveolar haemorrhage accompanied by anti-glomerular basement membrane (GBM) antibodies in serum or tissue. In >90% of patients with Goodpasture’s syndrome, anti-GBM antibodies can be detected in the serum [1]. Only 2% of the patients develop diffuse alveolar haemorrhage without clinically evident renal disease. Typically, young male smokers are affected by Goodpasture’s syndrome [2,3]. Here, we report the case of a 27-year-old Polish man who developed massive pulmonary haemorrhage without any clinical signs of renal dysfunction. Moreover, no circulating anti-GBM antibodies were detectable in his serum using common laboratory methods.