Case Study

Jesse is a 22 year old Caucasian male.  He is a university student who lives at home with his parents.  He is a smoker and an occasional intra-nasal cocaine user.

Medical Background:    allergic to penicillin, tonsils removed at age 7,  smoker ½ pack/day for 7 years

Admitting Diagnosis:     Goodpasture’s syndrome, Glomerulonephritis

Goodpasture syndrome: rare autoimmune disease; antibodies attack basement membranes in lungs and kidneys

Glomerulonephritis:  inflammation of glomerulus in kidney

Presented to ER with:    back pain below ribs, difficulty breathing, nausea, vomiting, pale skin, fatigue, weakness and confusion

Treatments:    corticosteroids (anti-inflammatories), immunosuppressive therapy - cyclophosphamide (treats autoimmune diseases) and plasmapheresis (return of blood components to plasma and rapidly removes circulating antibodies)

Outcome:      Jesse suffered severe glomerular damage which led to renal failure.   In addition to the treatments already mentioned, he is receiving hemodialysis three times per week.  He will be referred for renal transplantation.  

Social Worker – Tina