# A Unique Case of Goodpasture’s Syndrome-Induced Cardiorenal Syndrome

## TL;DR

A rare case of Goodpasture’s syndrome led to severe kidney and heart failure in a young man, highlighting unusual complications.

## Contribution

This is the first reported case of anti-GBM-positive Goodpasture’s syndrome causing cardiorenal syndrome with non-ischemic cardiomyopathy.

## Key findings

- The patient developed end-stage renal disease and cardiorenal syndrome despite standard treatment for Goodpasture’s syndrome.
- He experienced non-ischemic cardiomyopathy with systolic and diastolic heart failure.
- An automatic implantable cardioverter defibrillator was placed due to worsening cardiac function.

## Abstract

Goodpasture's syndrome (GPS) is a rare small vessel vasculitis characterized by circulating antibodies directed against the glomerular and alveolar basement membrane leading to renal and pulmonary manifestations. Here, we discuss a unique case of a 30-year-old Caucasian male smoker initially presenting with hemoptysis and anemia who was found to have biopsy-proven GPS with elevated anti-glomerular basement membrane (anti-GBM) antibodies. Unfortunately, the patient failed four months of standard treatment for GPS leading to end-stage renal disease (ESRD), while uniquely developing cardiorenal syndrome (CRS) with non-ischemic cardiomyopathy resulting in systolic and diastolic heart failure (HF). Despite aggressive medical management and hemodialysis, the patient’s cardiac function continued to decline and the decision was made to insert an automatic implantable cardioverter defibrillator (AICD). To our knowledge, this is the first reported case of an anti-GBM-positive GPS patient who developed dilated cardiomyopathy. The importance of this report is to illustrate the rarity of developing CRS with non-ischemic cardiomyopathy and congestive heart failure from GPS and highlight the difficulty of determining management changes beyond guideline-directed medical therapy (GDMT) in GPS to slow the progression of worsening cardiac function.