| CASE REPORT |
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| Year : 2023 | Volume
: 17
| Issue : 2 | Page : 266-268 |
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An unusual presentation of Goodpasture syndrome
Jisa George1, Buddhan Rajarathinam2, Rajkumar Kulasekaran3, Pranjali Kurhekar4
1 Department of General Medicine, ESIMC and PGIMSR, Chennai, Tamil Nadu, India
2 Senior Consultant Multidisciplinary ICU, Fortis Malar Hospital, Chennai, Tamil Nadu, India
3 Consultant Pulmonologist, Fortis Malar Hospital, Chennai, Tamil Nadu, India
4 Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
Correspondence Address:
Pranjali Kurhekar
Department of Anesthesiology, Sree Balaji Medical College and Hospital, Chrompet, Chennai - 600044, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sja.sja_566_22
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Goodpasture disease is an anti–glomerular basement membrane (anti-GBM) disease that manifests as progressive glomerulopathy and alveolar hemorrhage. Our case was a 68-year-old female who presented with decompensated liver disease (DCLD) with no prior history suggestive of liver disease. She had dyspnea, bilateral pitting edema, icterus with normal renal parameters, and elevated liver enzymes. Ultrasonogram revealed shrunken liver, ascites, and portal hypertension with normal renal cortex echogenicity. Over the next three days, she developed progressive oliguria, hematuria, and breathlessness, with arterial blood gas showing hypoxia with acidosis and hyperkalemia. Bronchoscopic alveolar lavage was suggestive of hemorrhagic fluid. The patient succumbed to the disease in 24 hours. Anti-GBM antibodies came positive by immunofluorescence assay which confirmed the diagnosis of Goodpasture syndrome. Unusual presentation of DCLD in our case resulted in a delay in diagnosis that could have been crucial in altering the outcome.
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