Am J Perinatol 2007; 24(10): 619-621
DOI: 10.1055/s-2007-992177
© Thieme Medical Publishers

Goodpasture's Disease in Pregnancy: Case Report and Review of the Literature

Tamera Hatfield1 , Ralph Steiger2 , Deborah A. Wing1
  • 1Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California
  • 2Department of Perinatal Services, Desert Regional Medical Center, Palm Springs, California
Further Information

Publication History

Publication Date:
30 October 2007 (online)

ABSTRACT

Goodpasture's disease is a rare phenomenon in pregnancy. It is characterized by antiglomerular basement membrane antibodies resulting in glomerulonephritis and pulmonary hemorrhage. We present a case of a patient with a preconceptional diagnosis of Goodpasture's disease and chronic hypertension. Multidisciplinary antepartum care included close monitoring and treatment of blood pressure, renal function, and fetal status. Our patient ultimately was delivered at 33 weeks for superimposed preeclampsia but recovered without incident. Her infant also did well after 36 days in the neonatal intensive care unit, requiring only supportive care. This case demonstrates that successful pregnancy outcomes can be achieved in patients with Goodpasture's disease with a careful multidisciplinary approach involving maternal fetal medicine and nephrology.

REFERENCES

  • 1 Turner A N, Rees A J. Goodpasture's disease and Alport's syndromes.  Annu Rev Med. 1996;  47 377-386
  • 2 Burns A P, Fisher M, Li P, Pusey C D, Rees A J. Molecular analysis of HLA class II genes in Goodpasture's disease.  QJM. 1995;  88 93-100
  • 3 Yankowitz J, Kuller J A, Thomas R L. Pregnancy complicated by Goodpasture syndrome.  Obstet Gynecol. 1992;  79 806-808
  • 4 Deubner H, Wagnild J P, Wener M H, Alpers C E. Glomerulonephritis with anti-glomerular basement membrane antibody during pregnancy: potential role of the placenta in amelioration of disease.  Am J Kidney Dis. 1995;  25(2) 330-335
  • 5 Wells S R, Kuller J A, Thorp Jr J M. Pregnancy in a patient with Goodpasture syndrome and renal transplantation.  Am J Perinatol. 1996;  13(2) 79-80
  • 6 Nilssen D E, Talseth T, Brodwall E K. The many faces of Goodpasture's syndrome.  Acta Med Scand. 1986;  220(5) 489-491
  • 7 Vasiliou D M, Maxwell C, Prakeshkumar S, Sermer M. Goodpasture syndrome in a pregnant woman.  Obstet Gynecol. 2005;  106 1196-1199
  • 8 Ramin S M, Vidaeff A C, Yeomans E R, Gilstrap III L C. Chronic renal disease in pregnancy.  Obstet Gynecol. 2006;  108(6) 1531-1539
  • 9 Jones D C, Hayslett J P. Outcome of pregnancy in women with moderate or severe renal insufficiency.  N Engl J Med. 1996;  335 226-232

Tamera HatfieldM.D. Ph.D. 

University of California, Irvine, Department of Obstetrics-Gynecology, 101 The City Drive

Suite 800, Building 56, ZOT 3200, Orange, CA 92868; reprints not available from the author

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