[79-year-old patient with pulmorenal syndrome].

HISTORY AND ADMISSION FINDINGS: A 79-year-old female patient was referred with acute renal failure requiring haemodialysis and haemoptysis.

INVESTIGATIONS: Kidney biopsy showed extracapillary proliferative glomerulonephritis with crescents in 7 from 15 glomeruli and sclerosis in the remaining. A computed tomography scan of the chest showed evidence of alveolar haemorrhage. Serologic testing revealed autoantibodies against the glomerular basement membrane (anti-GBM antibodies) and myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA).

DIAGNOSIS, TREATMENT AND COURSE: The patient was diagnosed with goodpasture's disease and underwent immunosuppressive therapy including prednisolone, cyclophosphamide pulses and plasmapheresis, resulting in clearance of anti-GBM antibodies and discontinuation of haemoptysis. Renal function, however, did not recover and the patient remained on dialysis.

CONCLUSIONS: Aggressive treatment including cyclophosphamide and plasma separation often ensures patient survival in goodpasture's disease, in most cases, however, renal function does not recover.