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Pulmonary renal syndrome: treatment of acute renal failure secondary to double positive goodpasture syndrome

Rajkumar Prakashbhai Doshi, Viralkumar Patel, Keyur Patel, Maulik Patel.

Abstract
This is a case of a 34 year old female who presented with lower epigastric pain, flank pain and hematuria. Her symptoms started two days after being treated on Trimethoprim+Sulfamethoxazole for urinary tract infection. Worsening of her symptoms despite switching to Cephalexin prompted her to come to the emergency department. On admission, her creatinine was 5.3 mg/dL with potassium of 5.2 mEq/L and albuminuria of 100 mg/dL. Chest computed tomography (CT) without contrast revealed findings consistent with goodpasture disease. Biopsy of the kidney confirmed diffuse necrotizing and crescentic glomerulonephritis consistent with anti-glomerular basement membrane antibody disease. She was treated with plasmapheresis and steroids with complete resolution of symptoms at follow up.

Key words: Acute renal failure, Goodpasture syndrome, Plasmapheresis



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