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Recurrent Massive Alveolar Hemorrhage, Crescentic Glomerulonephritis, and Necrotizing Vasculitis in a Patient With Rheumatoid Arthritis
Johanan E. Naschitz, MD;
Daniel Yeshurun, MD;
Yehuda Scharf, MD;
Ibrahim Sajrawi, MD;
Nissim B. Lazarov, MD;
Jochanan H. Boss, MD
Arch Intern Med. 1989;149(2):406-408.
Abstract
• A middle-aged man presented with recurrent alveolar hemorrhage, rheumatoid arthritis, and crescentic immune complex–mediated glomerulonephritis. Nail bed hemorrhages and necrotizing vasculitis were documented concomitantly with the clinical picture of Goodpasture's syndrome. Perusal of the literature disclosed two additional similar cases. It is suggested that Goodpasture's syndrome may evolve in the framework of rheumatoid vasculitis. While immunosuppressive therapy resulted in short-term remission, two of the three patients involved developed late-stage renal failure.
(Arch Intern Med 1989;149:406-408)
Author Affiliations
From the Departments of Internal Medicine A (Drs Naschitz and Yeshurun) and Pathology (Drs Sajrawi and Boss) and the Diagnostic Radiology Institute (Dr Lazarov), Haifa Medical Center, the Department of Rheumatology, Rambam Medical Center (Dr Scharf), and the Department of Medicine, Technion-Israel Institute of Technology (Drs Naschitz and Yeshurun), Haifa, Israel.
Footnotes
Accepted for publication Oct 20, 1988.
Reprint requests to Department of Internal Medicine A, Haifa Medical Center (Rothschild), PO Box 4940, Haifa 31048, Israel (Dr Naschitz).
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