Reactivation of Goodpasture Disease During the Third Trimester of Pregnancy

BACKGROUND: Active Goodpasture disease (GD) in pregnancy is extremely rare and can result in significant maternal and fetal morbidity. Relapse of GD in a subsequent pregnancy has not been reported. Factors associated with a relapse of GD are unknown. CASE: A woman in her second pregnancy presented with clinical findings of pre-eclampsia and biopsy evidence of GD in the third trimester. Her first puerperium was also complicated by GD, requiring temporary hemodialysis. After her second pregnancy she developed terminal renal failure. CONCLUSION: Active GD is extremely rare in pregnancy and has never been reported in 2 successive pregnancies in the same patient. Pregnancy and preeclampsia may be risk factors for a GD relapse, and women with GD contemplating pregnancy should be counseled accordingly.