Background: Goodpasture’s syndrome is a triad of alveolar hemorrhage, Glomerulonephritis and circulating anti Glomerular basement membrane antibodies, 25% of cases test positive for ANCA antibodies, this association is known as Double positive disease. This article describes a rare presentation of this entity and reviews available literature.
Case Report: 80 year old female presented with hemoptysis and renal failure, she tested positive for both p ANCA and anti glomerular basement membrane antibodies, and despite aggressive medical treatment, she suffered a frustrating outcome.
Conclusions: Double positive disease accounts for 25% of cases of Goodpasture’s syndrome, a suggested Pathophysiology of this association is the renal involvement in ANCA Vasculitis leading to the exposure of antigens from the basement membrane and the formation of antibodies.
This entity is believed to carry better prognosis when compared to isolated anti glomerular basement membrane disease.

Keywords: Anti-Glomerular Basement Membrane Disease, p-ANCA, Pulmonary renal syndrome, double positive disease