ABSTRACT
A 39-year old lady, admitted with a 15-day history of generalized fatigability, 7-day history of progressive shortness of breath associated with intermittent coughing up streaks of blood. Examination revealed a healthy looking female, she was pale, and mildly distressed. Chest examination showed bilateral lower crackles. CBC showed microcytic hypo chromic anemia with high erythrocyte sedimentation rate [ESR] 105 mm/hr. The initial chest X-ray showed bilateral lower infiltrates sparing the costophrenic angles. Although her initial serum creatinine was normal, she developed mild renal impairment during her hospital course. Renal biopsy was consistent with anti-glomerular basement membrane antibody-mediated disease [Goodpasture syndrome]. The hospital course was complicated by severe hypoxia, intensive care unit admission and intubation. The patient received the treatment of choice for Good pasture's syndrome i.e. plsmapharesis combined with prednisolone and cyclophsphamide, with excellent response. She was discharged home with a clear chest X-ray and a normal serum creatinine