Pregnancy complicated by Goodpasture syndrome

Goodpasture syndrome is characterized by pulmonary hemorrhage, glomerulonephritis, and an autoantibody to glomerular basement membrane antigens. Current management of this potentially lethal disease consists of glucocorticoids to control pulmonary hemorrhage, cytotoxic drugs to inhibit further renal damage, and plasma exchange to clear circulating anti-basement membrane antibodies. These treatment modalities pose difficult management issues during pregnancy. We describe a successful pregnancy outcome in a parturient with Goodpasture syndrome. Antepartum care included serial pulmonary and renal evaluations. In patients without disease progression, a favorable outcome may be possible.