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Nephrol Dial Transplant (2001) 16: 2082-2085
© 2001 European Renal Association-European Dialysis and Transplant Association

Case Report

Conversion of Goodpasture's syndrome into membranous glomerulonephritis

Jan Thomas Kielstein1,, Udo Helmchen2, Kai-Olaf Netzer3, Manfred Weber3, Hermann Haller and Jürgen Floege4

1 Division of Nephrology, Medical School Hannover, Hannover, 2 Department of Pathology, University of Hamburg, Hamburg, 3 Medizinische Klinik I, Krankenhaus Köln-Merheim, Köln and 4 Medizinische Klinik II, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany

Keywords: anti-GBM disease; GBM; Goodpasture's syndrome; membranous glomerulonephritis; podocyte



   Introduction
 
An autoimmune response to the non-collagenous NC-1 domain of the {alpha}3-chain of type IV collagen is the pathogenetic basis for the development of anti-glomerular basement membrane (GBM) disease. In Goodpasture's syndrome clinical involvement of both kidneys and lungs is present. In rare cases an association of Goodpasture's syndrome/anti-GBM disease with membranous glomerulonephritis has been reported [1,2]. In all of these cases an initially membranous glomerulonephritis evolved into Goodpasture's syndrome. Based on these clinical observations, it has been hypothesized that damage to the GBM in the course of membranous glomerulonephritis may have resulted in the release of normal or altered basement membrane material, leading to the formation of anti-GBM antibodies [2]. Here we describe a patient in whom the sequence of events was reversed, i.e. he presented with Goodpasture's syndrome and subsequently developed membranous glomerulonephritis.



   Case
 
Development of Goodpasture's syndrome
A 17-year-old Caucasian male with an unremarkable medical history presented . . . [Full Text of this Article]

Progression of Goodpasture's syndrome to membranous glomerulonephritis


   Discussion
 


   Notes
 


   References
 

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