Izgubljen bubreg u Goodpasture-ovom sindromu - prikaz slučaja

Abstract

Introduction: Goodpasture syndrome is a rare autoimmune syndrome with alveolar hemorrhages and glomerulonephritis caused by circulating antibodies against the glomerular basement membrane. Anti-glomerular-basement-membrane were administered against a non-collagen (NC-1) 3 chain of collagen type IV, which was found at the highest concentration in the basal membrane of renal and pulmonary capillaries. The aim of case report is a clinical overview of this rare and severe syndrome. Case report: The patient, 22-years-old was sent to the Center of Urgent Medicine of Clinical Center Kragujevac from General Hospital of Paraćin because of blood poisoning, fever, symptoms and signs of renal and respiratory weakness, and suspected of Wegener's disease. Antibodies were taken on the basement membrane of the glomerulus were resulted of enormously high. After due to the clinical and immunology diagnosis of Goodpasture syndrome, plasmapheresis treatment was initiated. The standard hemodialysis was continued. Following the guidelines protocols, patient received pulse dozes of cytostatics, corticosteroids, etc. Conclusion: The case report of our patient points to the necessity of multidisciplinary approach of the expert team, consisting of a nephrologist, pulmonologist, clinical pharmacologist and other specialists. The prognosis is good, if treatment is started before irreversible pulmonary and/or renal changes (respiratory and/or renal insufficiency). Goodpasture syndrome often progresses rapidly, so it can be fatal if it's delayed with the diagnosis and the treatment. Patients with Goodpasture's syndrome require adequate socio-medical care as a rare and severe syndrome.