Goodpasture syndrome
Revision as of 04:01, 24 January 2016 by 3amrbadawy (talk | contribs)
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
Differential Diagnosis
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
- See Glomerulonephritis
- Plasmapharesis shown to be beneficial [1]
- In severe cases may need:
- Rheumatology eval: Immunosuppressants
Disposition
Admit for:
- Decompensated disease
- Massive hemoptysis
- Acute glomerulonephritis
See Also
External Links
References
- ↑ 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