Recurrent Goodpasture's disease

ANTIGLOMERULAR basement membrane (anti-GBM) disease (Goodpasture's disease) is the combination of pulmonary hemorrhage, rapidly progressive glomerulonephritis, and circulating anti-GBM autoantibodies. A proportion of patients present with isolated nephritis, or rarely, isolated pulmonary hemorrhage in the presence of diagnostic autoantibodies. Goodpasture's disease is usually a monophasic illness, and the success of current treatment regimens has allowed many patients to survive for prolonged periods of time. There have been only a few case reports of clinical or serologic recurrence, and there are no adequate data on the long-term immunology of patients with recurrent disease. We report for the first time a patient with recurrent lung hemorrhage and nephritis in whom serologic data were available throughout a 12-year period. This case demonstrates the close association of disease activity with circulating anti-GBM antibody levels.