Goodpasture syndrome

Background

• Goodpasture syndrome (60%): diffuse pulmonary hemorrhage + acute glomerulonephritis.
• Goodpasture disease: glomerulonephritis alone (30%,) pulmonary sx 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 sx prior to pulmonary/renal complications
• Pulmonary
  • Cough, dyspnea, chest pain, hemoptysis, respiratory failure or pulmonary hemorrhage
• Renal
  • See Glomerulonephritis

Diagnosis

• Pulmonary
  • Depends whether pt stable or not
  • See hemoptysis
• Renal:

UA CBC Chemistry Albumin (often reduced in acute glomerulonephritis) C3, C4, ASO, ANCA

Management

• See Hemoptysis