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Case Reports in Pulmonology
Volume 2014 (2014), Article ID 398238, 7 pages
http://dx.doi.org/10.1155/2014/398238
Case Report

Goodpasture’s Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association

1Department of Histopathology, Post Graduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh 160012, India
2Department of Pulmonary Medicine, Post Graduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh 160012, India
3Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh 160012, India

Received 5 June 2014; Accepted 22 September 2014; Published 2 October 2014

Academic Editor: Shinichiro Ohshimo

Copyright © 2014 Amanjit Bal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Goodpasture’s syndrome is a rare clinical entity and is characterized by circulating autoantibodies which are principally directed against the glomerular/alveolar basement membrane. The etiology of Goodpasture’s syndrome is still unknown. Lung involvement occurs as a result of lung injury and the exposure of new epitopes to the immune system. Recently, several studies have suggested the role of silica as one of etiological factors in ANCA associated vasculitis and glomerulonephritis. Materials and Methods. We present a case of a 40-year-old welder with silicosiderosis, who developed anti-GBM disease with p-ANCA positivity. Case Report. Patient presented to an emergency with gradually increasing breathlessness along with renal failure and died after short hospital stay. Autopsy pathology findings revealed crescentic glomerulonephritis with linear glomerular basement membrane antibody deposition, splenic vasculitis, pulmonary haemorrhage, and pulmonary silicosiderosis. Conclusion. This case reinforces the role of environmental triggers like exposure to silica, metal dust, and tobacco in pathogenesis of Goodpasture’s syndrome and p-ANCA associated vasculitis.