Management of an Adult with Goodpasture’s Syndrome Following Brain Trauma with Extracorporeal Membrane Oxygenation: A Case Report

Wang Shan; Yin Haiyan; Zhu Youfeng; Tao Pei; Zhang Rui; Ma Yonghui; Wei Jianrui

doi:10.24920/003478

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Management of an Adult with Goodpasture’s Syndrome Following Brain Trauma with Extracorporeal Membrane Oxygenation: A Case Report

Chinese Medical Sciences Journal Vol. 34, Issue 3, Pages: 226-229(2019)

Case Report | Updated：2024-04-10

- Management of an Adult with Goodpasture’s Syndrome Following Brain Trauma with Extracorporeal Membrane Oxygenation: A Case Report
- Affiliations：
  
  1. 1 Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou 510220, China
  2. 2 Institute of Clinical Nutrition, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou 510220, China
- Author bio：
  
  *Tel: 86-18928900398, E-mail: jianrui_wei@sina.com
- Funds：
- DOI：10.24920/003478
  CLC：
- Received：18 June 2019，
  
  Published Online：18 June 2019，
  
  Published：18 June 2019
- Accepted：
Scan QR Code
Wang Shan, Yin Haiyan, Zhu Youfeng, et al. Management of an Adult with Goodpasture’s Syndrome Following Brain Trauma with Extracorporeal Membrane Oxygenation: A Case Report[J]. Chinese medical sciences journal, 2019, 34(3): 226-229.
DOI：

Wang Shan, Yin Haiyan, Zhu Youfeng, et al. Management of an Adult with Goodpasture’s Syndrome Following Brain Trauma with Extracorporeal Membrane Oxygenation: A Case Report[J]. Chinese medical sciences journal, 2019, 34(3): 226-229. DOI： 10.24920/003478.

摘要

患者男

22岁

因“跌倒致头晕、呕吐1天”入院

入院后第3天突发呼吸困难、低血氧

气管插管过程中见气道内弥漫性出血

呼吸机辅助通气难以纠正低氧血症。经股静脉-股动脉安置体外膜肺氧合（ECMO）后

患者的血氧饱和度得到明显改善。同时患者的肾功能急剧恶化

立即行持续性肾脏替代治疗（CRRT）后

患者的肾功能仍进行性恶化。尽管在患者的血清中未检测到抗肾小球基底膜抗体

但结合患者症状、体征及相关实验室检查

经过全院会诊讨论考虑为Goodpasture综合征。经过3天的激素冲击和血浆置换治疗后

患者的肾功能得到明显改善。最终顺利拔管出院。

Abstract

A 22-year-old man suffered from acute pulmonary hemorrhage and deteriorated renal function occurred within 3 days after traumatic brain injury. Mechanical ventilation cannot correct his severe hypoxemia

therefore

venoarterial extracorporeal membrane oxygenation (VA-ECMO) support was initiated and finally resolved his hypoxemia. Concomitantly

continuous renal replacement therapy was performed to improve his kidney function. Although no anti-glomerular basement membrane (anti-GBM) antibody was detected in serum

Goodpasture’s syndrome was considered. After treated with methylprednisolone pulse therapy and plasmapheresis

his renal function was significantly improved. ECMO was eventually discontinued after 60 hours of treatment and extubated on day 10. He was discharged home with normal pulmonary and renal functions.

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Keywords

references

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