Management Challenges in an Elderly Patient with Goodpasture's Syndrome and Multiple Comorbidities: A Case Report
Keywords:
Anti-GBM disease, Chronic kidney disease, Elderly, Goodpasture's syndrome, Haemodialysis, Multimorbidity, Nursing careAbstract
Background: Goodpasture's syndrome, also referred to as anti-glomerular basement membrane (anti-GBM) disease, is a rare autoimmune small-vessel disease characterized predominantly by rapidly progressive glomerulonephritis, with or without pulmonary haemorrhage. Although the disease can occur at any age, older patients may present with advanced renal impairment, multiple comorbidities, and complex diagnostic and therapeutic challenges.
Case Presentation: A 75-year-old woman with Goodpasture's syndrome and stage 5 chronic kidney disease, type 2 diabetes mellitus, hypertension, chronic anaemia, recurrent infections, pleural effusions, and a right radial artery pseudoaneurysm requiring long-term maintenance haemodialysis, plasmapheresis, blood transfusions, erythropoietin therapy, and multidisciplinary care was admitted to the hospital. Despite intensive treatment, the patient experienced recurrent fluid overload, persistent anaemia, hypoalbuminaemia, recurrent infections, and progressive functional decline.
Conclusion: This case highlights the complexity of managing Goodpasture's syndrome in an elderly patient with multiple comorbidities. Early diagnosis, individualized dialysis strategies, careful nursing assessment, nutritional support, and coordinated multidisciplinary management are essential to minimize complications and optimize patient outcomes.
