Crescentic glomerulonephritis and microangiopathic haemolytic anaemia in a patient with established systemic sclerosis

This article reports a case of Goodpasture's syndrome and microangiopathic haemolytic anaemia developing in a patient with a 2-year history of systemic sclerosis. Goodpasture's syndrome usually presents with lung haemorrhage and acute renal failure, and kidney biopsy typically shows crescentic glomerulonephritis with linear immunoglobulin staining on the glomerular basement membrane. Treatment of choice for Goodpasture's syndrome is immunosuppressive therapy and plasma exchange, which has greatly improved morbidity and mortality. This unusual case highlights that seemingly unrelated autoimmune diseases may coexist in one patient, and thorough clinical examination combined with serology and histology may be necessary for correct diagnosis.