A rare case of Goodpasture syndrome concomitant with bleeding jejunal Dieulafoy’s lesion

An 81-year-old man was diagnosed with Goodpasture syndrome (GS) because he met the criteria of positive anti-GBM antibodies, rapid progressive glomerulonephritis and pulmonary hemorrhage. After starting plasmapheresis and steroid pulse therapy, he experienced tarry stool and contrast-enhanced CT rev...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2020-06, Vol.13 (3), p.382-385
Main Authors: Kawabata, Hideaki, Kawakatsu, Yukino, Sone, Daiki, Yamaguchi, Katsutoshi, Inoue, Naonori, Ueda, Yuki, Okazaki, Yuji, Hitomi, Misuzu, Miyata, Masatoshi, Motoi, Shigehiro, Nishimura, Masayasu, Shikano, Tsutomu
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged, 80 and over
Anti-Glomerular Basement Membrane Disease - complications
Case Report
Colorectal Surgery
Endoscopy, Gastrointestinal - methods
Gastroenterology
Gastrointestinal Hemorrhage - complications
Gastrointestinal Hemorrhage - diagnostic imaging
Hemostatic Techniques
Hepatology
Humans
Jejunal Diseases - complications
Jejunal Diseases - diagnostic imaging
Male
Medicine
Medicine & Public Health
Surgical Oncology
Tomography, X-Ray Computed
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Summary:An 81-year-old man was diagnosed with Goodpasture syndrome (GS) because he met the criteria of positive anti-GBM antibodies, rapid progressive glomerulonephritis and pulmonary hemorrhage. After starting plasmapheresis and steroid pulse therapy, he experienced tarry stool and contrast-enhanced CT revealed an aneurysmal finding in the jejunum. Paroral enteroscopy showed a jejunal Dieulafoy’s lesion (DL) with gush-out hemorrhage. Hemostasis was successfully achieved by hemoclipping, and he then experienced no re-bleeding events. GS can present as a jejunal DL, and contrast-enhanced CT is useful for investigating the etiology and site of small intestinal bleeding, which can lead to smooth, effective endoscopic hemostasis.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-019-01078-3