[Goodpasture syndrome: re-exacerbations associated with intercurrent infections]. / Síndrome de Goodpasture: reagudizaciones relacionadas con infecciones intercurrentes.

A review is made of eleven patients diagnosed with Goodpasture syndrome from 1981-1992 to study the possible causes of re-exacerbation episodes in this syndrome. Twelve episodes were detected in eight patients. Eight episodes were chronologically associated with intercurrent bacterial infections, one with discontinuation of therapy, one with volume overloading, and a concomitant infectious symptomatology was present in two patients, although no organism was recovered. All re-exacerbations manifested as pulmonary hemorrhage and most of them occurred in the early months after diagnosis. We therefore believe that an early diagnosis and aggressive therapy of intercurrent infections in this syndrome is recommended to avoid the re-emergence of pulmonary hemorrhage, which occasionally compromises patient survival.

[Diffuse pulmonary hemorrhage syndrome at a regional hospital. Description and clinical course]. / Síndrome de hemorragia pulmonar difusa en un hospital regional. Descripción clínica y evolución.

The clinical characteristics and evolution of 15 patients with Diffuse Pulmonar Hemorrhage Syndrome are reviewed. According to etiology diseases are classified in three groups: 1) Basal Antimembrane Antibodies disease (66.6%), 2) Vasculitis-Granulomatosis (24.6%), and 3) Idiopathic (6.6%). Pulmonary Hemorrhage was the first manifestation of the primary disease in 80% of patients and was present in 100% of those patients with anemia and opacities in chest x-Ray and in 73% of those with renal insufficiency, nephritic sediment and respiratory insufficiency. To reach the etiological diagnosis, invasive techniques were needed in order to obtain samples for the pathology exam. Three patients died (20%) and 7 had a relapse (46.6%) during the first year. It is underlined the need of an empirical aggressive treatment with steroids and immune-suppress drugs before reaching the final etiological treatment.