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Cranfield A et al, 2015: Goodpasture's disease following extracorporeal shock wave lithotripsy: a case report & literature review.

Cranfield A, Mathavakkannan S.
The Renal Unit, Lister Hospital Stevenage, Hertfordshire, SG1 4AB, UK.

Abstract

Shock wave lithotripsy may unmask epitopes within the glomerular basement membrane, leading to the formation of anti-glomerular basement membrane (GBM) antibodies and clinical disease in susceptible individuals. Although rare, our case highlights the need for vigilant monitoring of renal function following extracorporeal shock wave lithotripsy. This may allow for early recognition, treatment and improved outcome of anti-GBM disease. 

Clin Case Rep. 2015 Mar;3(3):160-4. doi: 10.1002/ccr3.190. Epub 2014 Dec 4

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Comments 1

Peter Alken on Friday, 13 November 2015 11:30

Goodpasture´s syndrome leads to acute, severe renal and pulmonary problems. It is a rare disease with only one case per 2 million population per year.

I do not think that this justifies the conclusion that there is a need “for vigilant monitoring of renal function following extracorporeal shock wave lithotripsy” But it “supports the recommendation that anti-GBM antibodies should be determined in a patient who develops acute renal failure, allowing for earlier diagnosis and treatment leading to potentially improved outcomes in these cases.” With proper therapy less than a third of the patients will run into permanent renal insufficiency.

Goodpasture´s syndrome leads to acute, severe renal and pulmonary problems. It is a rare disease with only one case per 2 million population per year. I do not think that this justifies the conclusion that there is a need “for vigilant monitoring of renal function following extracorporeal shock wave lithotripsy” But it “supports the recommendation that anti-GBM antibodies should be determined in a patient who develops acute renal failure, allowing for earlier diagnosis and treatment leading to potentially improved outcomes in these cases.” With proper therapy less than a third of the patients will run into permanent renal insufficiency.
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