Display options
Share it on

NDT Plus. 2010 Oct;3(5):483-6. doi: 10.1093/ndtplus/sfq143. Epub 2010 Jul 27.

Rescue of renal function in a 3-year-old girl with Goodpasture's syndrome with a brief review of literature.

NDT plus

Mehul P Dixit, Rebecca Kirschner, Stella Bulimbasic, Naznin M Dixit, Alexis Harris


  1. Florida Children's Kidney Center, University of Central Florida College of Medicine , Orlando, FL , USA.
  2. Nephropath Associates, Little Rock, AR , USA.

PMID: 25984061 PMCID: PMC4421699 DOI: 10.1093/ndtplus/sfq143


Goodpasture's syndrome has been documented in only a handful of children under the age of four. We describe a 3-year-old girl presenting with anaemia and renal failure whose kidney biopsy showed anti-glomerular basement membrane (GBM) disease. She was treated aggressively with pulse steroids, plasmapheresis and monthly infusions of cyclophosphamide. After months of aggressive immunosuppression, her renal function normalized, and her anti-GBM antibody disappeared. A year after the onset, she underwent a second kidney biopsy for persistent proteinuria and hypertension that surprisingly showed focal sclerosing glomerulonephritis, an unreported finding at this age. The biopsy showed deposition of antibody on the GBM despite the fact that anti-GBM antibody had normalized in the serum 5 months earlier. Mycophenolate mofetil was added to the immunosuppression at that point. At her 3-year follow-up, creatinine clearance was 88.4 mL/min/1.73 m(2), proteinuria was 408 mg/day and blood pressure was controlled with enalapril 0.2 mg/kg/day. She has not had a relapse or abnormal anti-GBM antibody for 30 months, but her renal prognosis remains guarded. To our knowledge, this is the youngest patient to have a successful rescue of renal function after isolated Goodpasture's syndrome.

Keywords: acute renal failure; anti-glomerular basement membrane disease; hypertension; immunosuppression


  1. J Clin Invest. 1997 May 15;99(10):2470-8 - PubMed
  2. J Clin Apher. 1994;9(2):116-9 - PubMed
  3. Pediatr Nephrol. 2009 Jan;24(1):215-6 - PubMed
  4. Arch Dis Child. 1983 Sep;58(9):697-702 - PubMed
  5. Am J Kidney Dis. 1997 Nov;30(5):710-2 - PubMed
  6. Can Med Assoc J. 1964 Jan 4;90:5-9 - PubMed
  7. Fetal Pediatr Pathol. 2007 May-Jun;26(3):119-24 - PubMed
  8. Clin Pediatr (Phila). 1980 Jul;19(7):488-91 - PubMed
  9. Pediatr Nephrol. 1992 May;6(3):244-6 - PubMed
  10. Acta Paediatr Scand. 1981;70(3):435-9 - PubMed
  11. J Clin Apher. 1998;13(2):69 - PubMed
  12. Pediatr Nephrol. 1996 Dec;10(6):745-7 - PubMed
  13. J Am Soc Nephrol. 1999 Nov;10(11):2446-53 - PubMed

Publication Types