Goodpasture syndrome

Background

  • Goodpasture syndrome (60%): diffuse pulmonary hemorrhage + acute glomerulonephritis
  • Goodpasture disease: glomerulonephritis alone (30%,) pulmonary symptoms alone (10%,)
  • Anti-GBM disease is most precise term for both entities
    • Type II hypersensitivty causing linear IG deposition in glomerular and alveolar BM
    • Triggered by:
      • Sepsis
      • URI
      • Inhalation injury
      • Smoking
      • Pulmonary edema

Clinical Features

  • Constitutional symptoms prior to pulmonary/renal complications
  • Pulmonary
    • Cough, dyspnea, chest pain, hemoptysis, respiratory failure or pulmonary hemorrhage
  • Renal

Differential Diagnosis

Hemoptysis

Causes of Glomerulonephritis

Evaluation

  • Pulmonary
    • Depends whether patient stable or not
    • See hemoptysis
  • Renal:
  • Urinalysis, CBC, Chemistry, Albumin (often reduced in acute glomerulonephritis,) C3, C4, ASO, ANCA

Management

Disposition

Admit for:

  • Decompensated disease
  • Massive hemoptysis
  • Acute glomerulonephritis

See Also

External Links

References

  • Chan AL, Louie S, Leslie KO, Juarez MM, Albertson TE. Cutting edge issues in Goodpasture's disease. Clin Rev Allergy Immunol. 2011 Oct. 41(2):151-62.
  • Kathuria, P; Sanghera, P; Stevenson, FT; Sharma, S; Lederer, E; Lohr, JW; Talavera, F; Verrelli, M (21 May 2013). Batuman, C, ed. "Goodpasture Syndrome". Medscape Reference. WebMD. Retrieved 23 Jan 2016
  1. Levy JB, Turner AN, Rees AJ, Pusey CD. Long-term outcome of anti-glomerular basement membrane antibody disease treated with plasma exchange and immunosuppression. Ann Intern Med. 2001 Jun 5. 134(11):1033-42