Spontaneous Remission in Goodpasture Syndrome and Relapse 5 Years Later-A Case Report

Goodpasture症候群是一個罕見的自體免疫疾病，在早期這個疾病的預後並不好。而因為這個疾病引起的嚴重腎衰竭很少會恢復，只有早期的發現，才能有較好的預後並避免嚴重的後遺症。但是在少數的病人卻可以看到自發性的恢復。在這個案例，我們可以看到此案例一開始的表現是輕微發燒、慢性咳嗽、咳血以及胸部X光片異常的多處浸潤。但並沒有體重減輕以及夜間盜汗的狀況。這個案例曾在五年前發現過一樣的狀況，並且有被懷疑是肺結核的感染。然而，這次住院中我們有注意到此案例有輕微血尿合併蛋白尿。經過了腎臟切片以及血清抗基底膜抗體（anti-GBM antibody）的檢查，我們確診此個案為Goodpasture症候群。經過立即的免疫抑制藥物以及血漿置換術的處理，此案例的狀況恢復良好並已經在門診追蹤了12個月。

關鍵字

Goodpasture症候群；自發性；抗基底膜抗體

並列摘要

Goodpasture syndrome is a rare autoimmune disease which has had a poor prognosis in the past. Recovery from severe renal failure due to Goodpasture syndrome is uncommon. Only early detection of this disease can improve the outcome and prevent long-term morbidities. However, some cases will recover spontaneously. In the present case, the initial symptoms and signs were intermittent low-grade fever, chronic cough, and hemoptysis. Chest X-ray showed multiple alveolar patches. No body weight loss and no night sweating were noted. The patient had the same symptoms 5 years previously and they resolved spontaneously. Pulmonary tuberculosis was suspected at that time. This time, hematuria with foamy urine developed during admission, and after renal biopsy and anti-GBM antibody survey, Goodpasture syndrome was diagnosed. The patient’s condition improved after immediate treatment with immunosuppressive drugs and hemodialysis, and she was still well after regular follow-up for 12 months.

並列關鍵字

Goodpasture syndrome ； spontaneous remission ； relapse ； anti-GBM

國際替代計量

Spontaneous Remission in Goodpasture Syndrome and Relapse 5 Years Later-A Case Report

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