Alix Pascaline M, Belloi Amélie, Berthoux Émilie, Dijoud Frédérique, Villar Emmanuel, Pariset Caroline
Service de néphrologie, hôpital Édouard-Herriot, hospices civils de Lyon, 3, place d'Arsonval, 69347 Lyon cedex, France.
Service de néphrologie, centre hospitalier Saint-Joseph-Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France.
Nephrol Ther. 2018 Apr;14(2):105-108. doi: 10.1016/j.nephro.2017.09.004. Epub 2017 Dec 28.
Goodpasture's syndrome is a triad of anti-glomerular basement membrane (anti-GBM) circulating antibodies, glomerulonephritis and pulmonary hemorrhage. We reported a 65-year-old woman with headaches, asthenia and weight loss. Giant cell arteritis was confirmed by temporal artery biopsy. The patient had associated renal condition with moderate acute renal failure, proteinuria and haematuria. Renal biopsy showed extracapillary glomerulonephritis and linear staining of immunoglobulins G along glomerular basement membrane. There was no clinical pulmonary involvement. Anti-MBG antibody was positive and allowed Goodpasture's syndrome diagnosis. The patient was treated with corticoids and cyclophosphamide. Patient's condition and renal function improved quickly and anti-MBG antibodies became negative. Goodpasture's syndrome may be characterized by isolated renal expression without pulmonary involvement. We described for the first time association of Goodpasture's syndrome with giant cell arteritis.
古德帕斯彻综合征是由抗肾小球基底膜(抗GBM)循环抗体、肾小球肾炎和肺出血组成的三联征。我们报告了一名65岁女性,有头痛、乏力和体重减轻症状。颞动脉活检确诊为巨细胞动脉炎。该患者伴有肾脏疾病,有中度急性肾衰竭、蛋白尿和血尿。肾活检显示毛细血管外肾小球肾炎以及免疫球蛋白G沿肾小球基底膜呈线性染色。无临床肺部受累表现。抗MBG抗体阳性,确诊为古德帕斯彻综合征。患者接受了皮质类固醇和环磷酰胺治疗。患者病情和肾功能迅速改善,抗MBG抗体转阴。古德帕斯彻综合征可能以无肺部受累的孤立性肾脏表现为特征。我们首次描述了古德帕斯彻综合征与巨细胞动脉炎的关联。