Evidence of both anti-GBM and immune complex mediated pathogenesis in the initial phase of Goodpasture's syndrome

A 19 year old women presented with pulmonary hemorrhage, rapidly progressive glomerulonephritis and antiglomerular basement membrane antibody in her serum. In the initial phase of the disease a double layered linear deposit of IgG was seen on the glomerular capillary basement membrane together with a finely granular or focal and lumpy single layer deposit of C3 and numerous small subepithelial electron dense deposits. These findings are suggestive of the simultaneous occurrence of anti-GBM and immune complex glomerulonephritis.