Abstract

Background: Pulmonary involvement in Goodpasture's syndrome is exceptionally isolated without renal impairment. Usual lung damage includes alveolar hemorrhage resulting in pulmonary-renal syndrome. Isolated and atypical lung involvement can precede kidneys damage.
Case presentation: We report the case of an 80 year-old man admitted for dyspnea related to a tumor-like lung lesion which malignant nature we were unable to confirm. Three months later, the patient presented acute renal failure with rapidly progressive glomerulonephritis leading to the diagnosis of anti-glomerular basement membrane disease while the lung lesion remained stable. He received corticosteroid and immunosuppressive therapy with partially favorable renal outcome and complete regression of the lung lesion.
Conclusion: Slight modifications of the urinary sediment should be sought in case of lung abnormalities. Anti-glomerular basement membrane antibodies must be considered in case of any kidney damage associated with pulmonary involvement even if atypical.

Key words: Goodpasture's syndrome, pulmonary alveolar hemorrhage, rapidly progressive glomerulonephritis, crescentic glomerulonephritis, lung mass, case report.