К вопросу о сложности диагностики синдрома Гудпасчера
К вопросу о сложности диагностики синдрома Гудпасчера
Для цитирования: Подзолков В.И., Махнач Г.К., Ишина Т.И. и др. К вопросу о сложности диагностики синдрома Гудпасчера. Терапевтический архив. 2019; 91 (3): #–67. DOI: 10.26442/00403660.2019.03.000044
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Podzolkov V.I., Makhnach G.K., Ishina T.I., et al. Difficulties in Goodpasture's syndrome diagnosing. Therapeutic Archive. 2019; 91 (3): #–67. DOI: 10.26442/00403660.2019.03.000044
К вопросу о сложности диагностики синдрома Гудпасчера
Для цитирования: Подзолков В.И., Махнач Г.К., Ишина Т.И. и др. К вопросу о сложности диагностики синдрома Гудпасчера. Терапевтический архив. 2019; 91 (3): #–67. DOI: 10.26442/00403660.2019.03.000044
________________________________________________
Podzolkov V.I., Makhnach G.K., Ishina T.I., et al. Difficulties in Goodpasture's syndrome diagnosing. Therapeutic Archive. 2019; 91 (3): #–67. DOI: 10.26442/00403660.2019.03.000044
Обсуждаются проблемы диагностики и лечения анти-БМК-ассоциированной болезни (синдрома Гудпасчера) – редкого, тяжелого прогрессирующего заболевания, ассоциированного с образованием антител к гломерулярной мембране [анти-БМК (anti-GBM)], при котором развивается легочно-почечный синдром, т.е. одновременное диффузное геморрагическое поражение легких в сочетании с острым или быстропрогрессирующим гломерулонефритом. Главная проблема – это поздняя диагностика заболевания, когда терапия заболевания уже малоэффективна.
В статье приведены современные сведения об эпидемиологии, этиологии и патогенезе, принципах диагностики и лечения этого редкого заболевания, а также клиническое наблюдение пациента с синдромом Гудпасчера. Определены особенности течения болезни у данного больного.
The article analyzes the diagnosis and treatment of anti-GBM antibody disease (Goodpasture's syndrome) – a rare, severe progressive disease, associated with anti-glomerular basement membrane antibody-induced pulmonary hemorrhage and glomerulonephritis. The main problem of this pathology is late diagnosis, resulted in ineffective treatment. The article provides current information on the epidemiology, etiology and pathogenesis, diagnosis, and treatment of Goodpasture’s syndrome, as well as clinical case of a patient with this rare disease.
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2. Stanton MC, Tange JD. Goodpasture's syndrome (pulmonary haemorrhage associated with glomerulonephritis). Australasian annals of medicine. 1958;7(2):132-44.
3. Silvarino R, Noboa O, Cervera R. Anti-glomerular basement membrane antibodies. Israel Medical Association J. 2014;16(11):727-32.
4. Hellmark T, Segelmark M. Diagnosis and classification of Goodpasture's disease (anti-GBM). J Autoimmunity. 2014;48-49:108-12. https://doi.org/10.1016/j.jaut.2014.01.024
5. Yang R, Cui Z, Zhao J, Zhao MH. The role of HLA-DRB1 alleles on susceptibility of Chinese patients with anti-GBM disease. Clinical Immunology. 2009;133(2):245-50. https://doi.org/10.1016/j.clim. 2009.07.005
6. Meyera D, Colesb A, Oyuelac P, et al. Case report of anti-glomerular basement membrane disease following alemtuzumab treatment of relapsing–remitting multiple sclerosis. Multiple Sclerosis and Related Disorders. 2013;2(1):60-3. https://doi.org/10.1016/j.msard.2012.07. 002
7. Ohlsson S, Herlitz H, Lundberg S, et al. Circulating Anti-Glomerular Basement Membrane Antibodies With Predominance of Subclass IgG4 and False-Negative Immunoassay Test Results in Anti-Glomerular Basement Membrane Disease. Amer J Kidney Diseases. 2014;63:289-93. https://doi.org/10.1053/j.ajkd.2013.08.032
8. Cui Z, Zhao MH. Advances in human antiglomerular basement membrane disease. Nature Reviews Nephrology. 2011;7(12):697-705. https://doi.org/10.1038/nrneph.2011.89
9. Grecoa A, IdaRizzo M, DeVirgilio A, et al. Goodpasture's syndrome: A clinical update. Autoimmunity Reviews. 2015;14(3):246-53. https://doi.org/10.1016/j.autrev.2014.11.006
10. Feragalli B, Mantini C, Sperandeo M, Galluzzo M, Belcaro G, Tartaro A, et al. The lung in systemic vasculitis: radiological patterns and differential diagnosis. The British J Radiology. 2016;89:20150992. https://doi.org/10.1259/bjr.20150992
________________________________________________
1. Mukhin NA. Goodpasture`s syndrome: pathogenesis, diagnosis, treatment. Pharmateca. 2011;18:8-14 (In Russ.)
2. Stanton MC, Tange JD. Goodpasture's syndrome (pulmonary haemorrhage associated with glomerulonephritis). Australasian annals of medicine. 1958;7(2):132-44.
3. Silvarino R, Noboa O, Cervera R. Anti-glomerular basement membrane antibodies. Israel Medical Association J. 2014;16(11):727-32.
4. Hellmark T, Segelmark M. Diagnosis and classification of Goodpasture's disease (anti-GBM). J Autoimmunity. 2014;48-49:108-12. https://doi.org/10.1016/j.jaut.2014.01.024
5. Yang R, Cui Z, Zhao J, Zhao MH. The role of HLA-DRB1 alleles on susceptibility of Chinese patients with anti-GBM disease. Clinical Immunology. 2009;133(2):245-50. https://doi.org/10.1016/j.clim. 2009.07.005
6. Meyera D, Colesb A, Oyuelac P, et al. Case report of anti-glomerular basement membrane disease following alemtuzumab treatment of relapsing–remitting multiple sclerosis. Multiple Sclerosis and Related Disorders. 2013;2(1):60-3. https://doi.org/10.1016/j.msard.2012.07. 002
7. Ohlsson S, Herlitz H, Lundberg S, et al. Circulating Anti-Glomerular Basement Membrane Antibodies With Predominance of Subclass IgG4 and False-Negative Immunoassay Test Results in Anti-Glomerular Basement Membrane Disease. Amer J Kidney Diseases. 2014;63:289-93. https://doi.org/10.1053/j.ajkd.2013.08.032
8. Cui Z, Zhao MH. Advances in human antiglomerular basement membrane disease. Nature Reviews Nephrology. 2011;7(12):697-705. https://doi.org/10.1038/nrneph.2011.89
9. Grecoa A, IdaRizzo M, DeVirgilio A, et al. Goodpasture's syndrome: A clinical update. Autoimmunity Reviews. 2015;14(3):246-53. https://doi.org/10.1016/j.autrev.2014.11.006
10. Feragalli B, Mantini C, Sperandeo M, Galluzzo M, Belcaro G, Tartaro A, et al. The lung in systemic vasculitis: radiological patterns and differential diagnosis. The British J Radiology. 2016;89:20150992. https://doi.org/10.1259/bjr.20150992