Cerebral involvement in a patient with Goodpasture's disease due to shortened induction therapy: a case report.

Journal of Medical Case Reports
Christoph PreulChristoph Terborg

Abstract

Goodpasture's disease is a rare immunological disease with formation of pathognomonic antibodies against renal and pulmonary basement membranes. Cerebral involvement has been reported in several cases in the literature, yet the pathogenetic mechanism is not entirely clear. A 21-year-old Caucasian man with Goodpasture's disease and end-stage renal disease presented with two generalized seizures after a period of mild cognitive disturbance. Blood pressure and routine laboratory tests did not exceed the patient's usual values, and examination of cerebrospinal fluid was unremarkable. Cerebral magnetic resonance imaging (MRI) revealed multiple cortical and subcortical lesions on fluid-attenuated inversion recovery sequences. Since antiglomerular basement membrane antibodies were found to be positive with high titers, plasmapheresis was started. In addition, cyclophosphamide pulse therapy was given on day 13. Encephalopathy and MRI lesions disappeared during this therapy, and antiglomerular basement membrane antibodies were significantly reduced. Previous immunosuppressive therapy was performed without corticosteroids and terminated early after 3 months. The differential diagnostic considerations were cerebral vasculitis and posterio...Continue Reading

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Citations

May 29, 2012·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Tobias LahmerKlaus Thürmel
Sep 2, 2020·Modern Rheumatology Case Reports·Yumeko Taniguchi, Ryosuke Hanaoka

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Methods Mentioned

BETA
biopsy
X-ray

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