GLOMERULONEPHRITIS-GOODPASTURE SYNDROME

SUMMARY

1. Anti-GBM antibodies in the serum & pulmonary hemorrhage. This disease is not a vasculi­tis.

2. Patients present with an active urine sediment and hemoptysis with dyspnea.

3. Antibodies that attack the glomerular (and sometimes pulmonary) basement membrane(s) are formed in response to an unknown stimulus.

4. Renal biopsy makes the diagnosis by revealing anti-GBM lgG deposited in a linear fashion along the GBM. Anti-GBM antibodies in the serum make the diagnosis.

5. Differentiate from Wagner’s granulomatosis: more likely to be c-ANCA-positive.

6. Treatment of Goodpasture syndrome is plasmapheresis (to remove the antibodies) with immunomodulation (ste­roids & cyclophosphamide).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].