Anti-basement membrane antibody disease with severe pulmonary haemorrhage and normal renal function.

A case of anti-basement membrane disease with severe pulmonary haemorrhage and normal renal function is reported. In 1919 Goodpasture described a syndrome of glomerulonephritis and pulmonary haemorrhage.' Half a century later both manifestations were shown to be induced by circulating autoantibodies that reacted with alveolar and glomerular basement membranes.2 We present a case with severe pulmonary haemorrhage mediated by anti-basement membrane antibody in which renal function was normal. Case report A previously healthy 20 year old cigarette smoking farmer was referred complaining of dyspnoea and progressive haemoptysis of four days' duration after accidental exposure to fumes of fungicides containing metalaxyl (8%) and mancozeb (64%). He was pale, weak, sweating, and febrile (38 5°C). His pulse rate was 104/min, blood pressure 110/50 mm Hg, and respiratory rate 26/min. A chest radiograph showed diffuse fluffy infiltrates predominantly in the lower lobes. The erythrocyte sedimentation rate was 80 mm in one 68 group.bmj.com on June 25, 2017 Published by http://thorax.bmj.com/ Downloaded from