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[Variable presentation of antiglomerular basement membrane (anti-GBM) disease: rapid recognition vitally important.] Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] Journal article

 
van Galen KP, Oswald LM, van den Aardweg JG, Stam F, van den Berg JG, Bax WA 
[Variable presentation of antiglomerular basement membrane (anti-GBM) disease: rapid recognition vitally important.] [English Abstract, Journal Article]
Ned Tijdschr Geneeskd 2009.


The classic clinical presentation of anti-GBM disease, or Goodpasture's disease, is pulmonary haemorrhage in combination with rapidly progressive glomerulonephritis. However, presenting symptoms vary considerably. To illustrate this, this article describes 3 male patients with anti-GBM disease, aged 25, 27 and 25 years respectively. The first patient presented with massive haemoptysis without glomerulonephritis, the second patient presented with a microcytic anaemia, caused by subclinical alveolar bleeding, and the third patient presented with rapidly progressive glomerulonephritis in combination with respiratory failure. All 3 patients required mechanical ventilation but did survive. Two patients progressed to end-stage renal disease (ESRD). Earlier recognition might prevent respiratory failure and ESRD. Therefore, despite heterogeneous clinical presentation, immediate recognition of anti-GBM disease is vitally important in view of the potentially lethal consequences if left untreated.



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