A Unique Case of Goodpasture's Syndrome-Induced Cardiorenal Syndrome

Division

West Florida

Hospital

Medical Center of Trinity

Document Type

Case Report

Publication Date

7-10-2024

Keywords

anti-gbm disease, automated implantable cardiac defibrillator (aicd), cardiorenal syndrome; congestive heart failure, dilated cardiomyopathy, goodpasture's syndrome

Disciplines

Cardiology | Cardiovascular Diseases | Immune System Diseases | Medicine and Health Sciences | Respiratory Tract Diseases

Abstract

Goodpasture's syndrome (GPS) is a rare small vessel vasculitis characterized by circulating antibodies directed against the glomerular and alveolar basement membrane leading to renal and pulmonary manifestations. Here, we discuss a unique case of a 30-year-old Caucasian male smoker initially presenting with hemoptysis and anemia who was found to have biopsy-proven GPS with elevated anti-glomerular basement membrane (anti-GBM) antibodies. Unfortunately, the patient failed four months of standard treatment for GPS leading to end-stage renal disease (ESRD), while uniquely developing cardiorenal syndrome (CRS) with non-ischemic cardiomyopathy resulting in systolic and diastolic heart failure (HF). Despite aggressive medical management and hemodialysis, the patient's cardiac function continued to decline and the decision was made to insert an automatic implantable cardioverter defibrillator (AICD). To our knowledge, this is the first reported case of an anti-GBM-positive GPS patient who developed dilated cardiomyopathy. The importance of this report is to illustrate the rarity of developing CRS with non-ischemic cardiomyopathy and congestive heart failure from GPS and highlight the difficulty of determining management changes beyond guideline-directed medical therapy (GDMT) in GPS to slow the progression of worsening cardiac function.

Publisher or Conference

Cureus

Link to Full Text

Share

COinS