A Case of Goodpasture's Syndrome in a Patient with Graves' Disease / 대한신장학회잡지

ABSTRACT

Goodpasture's syndrome (GS) is characterized by lung hemorrhage and glomerulonephritis and caused by autoimmune reaction between anti-glomerular basement membrane (GBM) autoantibodies and the alpha 3 (type IV) collagen chain. Some reports suggested that patients with anti-GBM autoantibody could be related with other autoimmune diseases including Graves' disease. We report a case of 14-year-old girl with Graves' disease treated with PTU for 4 years, who was admitted because of hemoptysis and dyspnea. Laboratory values included a serum creatinine value of 0.7 mg/dL, BUN 22 mg/dL, hemoglobin 3.9 g/mm3 and albumin 3.2 mg/dL. The thyroid function tests showed normal serum T3 and free T4, suppressed TSH, and elevated thyroglobulin Ab and TSH-R-Ab levels. Urinalysis showed 2+ for protein and many dysmorphic RBC/HPF. Both anti-GBM Ab and pANCA were positive serologically. In renal biopsy, the glomeruli showed mesangial proliferation and crescent formation with linear deposits of IgG along the GBM. This case is to represent the GS of patient with Graves' disease referring to medical documents.