Goodpasture Syndrome With Recovery After Renal Failure

GOODPASTURE syndrome is usually characterized by fulminant glomerulonephritis and hemorrhagic pneumonitis. It is often fatal within a few months. Recovery of function in advanced renal failure is considered to be so unlikely that bilateral nephrectomy has been used in an attempt to ameliorate life-threatening pulmonary hemorrhage.¹ Although several patients with mild to moderate renal insufficiency have shown stabilization or improvement, only one patient has recovered function after the onset of renal failure and that patient apparently had at least some degree of acute tubular necrosis.²

We describe a similar patient in whom pulmonary hemorrhage subsided and renal function improved over a long period of follow-up without bilateral nephrectomy.

Report of a Case  A 48-year-old man was hospitalized after several weeks of increasing dyspnea and pleuritic chest pain. In the first week, he had extensive bilateral lung infiltrates and hemoptysis. He was given 6 units of blood to maintain