Pulmonary haemorrhage secondary to Goodpasture syndrome

Case contributed by Dr Jeffrey Lai

Presentation

Dyspnoea

Patient Data

Age: 19
Gender: Female

The tip of the CVC is projecting over the SVC. Minor hazy airspace opacification in the right mid and lower zones. The pleural space are clear. Cardiomediastinal contours are normal.

Non contrast scans were performed due to impaired renal function.

There is diffuse patchy ground-glass opacity within both lungs predominately within the upper lobes and apical lower lobes with relative sparing of the bases. Compared with the prior examination from a month ago this has improved within the right lung but is more confluent within the left lung, with infiltrates seen both centrally and peripherally. No interlobular septal thickening or nodules. The airways are normal. Pleural spaces are clear.

No pericardial effusion. No thoracic lymphadenopathy. No suspicious osseous lesions.

Conclusion:

Diffuse alveolar infiltrates predominately within the upper lobes and apical lower lobes appear more confluent on the left and improved on the right compared with one month ago. Given the patient's history of Goodpasture syndrome, appearances are in keeping with pulmonary haemorrhage.

Case Discussion

Goodpasture syndrome is due to anti-GBM autoantibodies and causes pulmonary haemorrhage and glomerulonephritis.

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Case information

rID: 38307
Case created: 14th Jul 2015
Last edited: 16th Jul 2017
System: Chest
Inclusion in quiz mode: Included

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