eMedicine Specialties > Nephrology > Glomerular Diseases

Goodpasture Syndrome: Multimedia

Author: Frazier T Stevenson, MD, Associate Professor of Clinical Medicine and Director of Education Development, University of California Davis School of Medicine
Coauthor(s): Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital; Mauro Verrelli, MD, FRCP(C), FACP, Assistant Professor, Department of Medicine, Section of Nephrology, University of Manitoba, Canada
Contributor Information and Disclosures

Updated: Oct 13, 2009

Multimedia

Goodpasture syndrome. A 45-year-old man was admit...
(Enlarge Image)
Media file 1: Goodpasture syndrome. A 45-year-old man was admitted to the intensive care unit with respiratory failure secondary to massive hemoptysis and acute renal failure. The antiglomerular basement membrane antibodies were strongly positive. The autopsy showed consolidated lung from extensive bleeding, which led to asphyxiation.
[ CLOSE WINDOW ]
Goodpasture syndrome. A 45-year-old man was admit...

Goodpasture syndrome. A 45-year-old man was admitted to the intensive care unit with respiratory failure secondary to massive hemoptysis and acute renal failure. The antiglomerular basement membrane antibodies were strongly positive. The autopsy showed consolidated lung from extensive bleeding, which led to asphyxiation.

Goodpasture syndrome. Close-up view of gross path...
(Enlarge Image)
Media file 2: Goodpasture syndrome. Close-up view of gross pathology in a 45-year-old man admitted to the intensive care unit with respiratory failure secondary to massive hemoptysis and acute renal failure. The antiglomerular basement membrane antibodies were strongly positive. The autopsy showed consolidated lung from extensive bleeding, which led to asphyxiation.
[ CLOSE WINDOW ]
Goodpasture syndrome. Close-up view of gross path...

Goodpasture syndrome. Close-up view of gross pathology in a 45-year-old man admitted to the intensive care unit with respiratory failure secondary to massive hemoptysis and acute renal failure. The antiglomerular basement membrane antibodies were strongly positive. The autopsy showed consolidated lung from extensive bleeding, which led to asphyxiation.

Cytoplasmic antineutrophilic cytoplasmic antibodi...
(Enlarge Image)
Media file 3: Cytoplasmic antineutrophilic cytoplasmic antibodies (c-ANCA), which can appear in Goodpasture syndrome, are also commonly observed in Wegener granulomatosis and other vasculitides.
[ CLOSE WINDOW ]
Cytoplasmic antineutrophilic cytoplasmic antibodi...

Cytoplasmic antineutrophilic cytoplasmic antibodies (c-ANCA), which can appear in Goodpasture syndrome, are also commonly observed in Wegener granulomatosis and other vasculitides.

Perinuclear antineutrophilic cytoplasmic antibodi...
(Enlarge Image)
Media file 4: Perinuclear antineutrophilic cytoplasmic antibodies (p-ANCA), which can appear in Goodpasture syndrome, are also observed in Churg-Strauss vasculitis and occasionally in Wegener granulomatosis.
[ CLOSE WINDOW ]
Perinuclear antineutrophilic cytoplasmic antibodi...

Perinuclear antineutrophilic cytoplasmic antibodies (p-ANCA), which can appear in Goodpasture syndrome, are also observed in Churg-Strauss vasculitis and occasionally in Wegener granulomatosis.

This is a renal biopsy slide of a patient who pre...
(Enlarge Image)
Media file 5: This is a renal biopsy slide of a patient who presented with hemoptysis and hematuria. The renal biopsy revealed crescentic glomerulonephritis, which may be caused by systemic lupus erythematosus, vasculitis, or Goodpasture syndrome.
[ CLOSE WINDOW ]
This is a renal biopsy slide of a patient who pre...

This is a renal biopsy slide of a patient who presented with hemoptysis and hematuria. The renal biopsy revealed crescentic glomerulonephritis, which may be caused by systemic lupus erythematosus, vasculitis, or Goodpasture syndrome.

This image of direct immunofluorescence shows smo...
(Enlarge Image)
Media file 6: This image of direct immunofluorescence shows smooth linear staining of the basement membrane secondary to immunoglobulin G deposition. This confirms the diagnosis of Goodpasture syndrome. Image courtesy of K. Orr, MD.
[ CLOSE WINDOW ]
This image of direct immunofluorescence shows smo...

This image of direct immunofluorescence shows smooth linear staining of the basement membrane secondary to immunoglobulin G deposition. This confirms the diagnosis of Goodpasture syndrome. Image courtesy of K. Orr, MD.

Goodpasture syndrome. A 35-year-old man who previ...
(Enlarge Image)
Media file 7: Goodpasture syndrome. A 35-year-old man who previously smoked cigarettes heavily, developed massive hemoptysis. The blood work showed positive anti–glomerular basement membrane antibodies.
[ CLOSE WINDOW ]
Goodpasture syndrome. A 35-year-old man who previ...

Goodpasture syndrome. A 35-year-old man who previously smoked cigarettes heavily, developed massive hemoptysis. The blood work showed positive anti–glomerular basement membrane antibodies.

More on Goodpasture Syndrome

Overview: Goodpasture Syndrome
Differential Diagnoses & Workup: Goodpasture Syndrome
Treatment & Medication: Goodpasture Syndrome
Follow-up: Goodpasture Syndrome
Multimedia: Goodpasture Syndrome
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Zhao J, Cui Z, Yang R, et al. Anti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severity. Kidney Int. Sep 9 2009;[Medline].

  2. Yang R, Cui Z, Zhao J, et al. The role of HLA-DRB1 alleles on susceptibility of Chinese patients with anti-GBM disease. Clin Immunol. Aug 3 2009;[Medline].

  3. Yang R, Hellmark T, Zhao J, et al. Levels of epitope-specific autoantibodies correlate with renal damage in anti-GBM disease. Nephrol Dial Transplant. Jun 2009;24(6):1838-44. [Medline].

  4. Zhao J, Yan Y, Cui Z, et al. The immunoglobulin G subclass distribution of anti-GBM autoantibodies against rHalpha3(IV)NC1 is associated with disease severity. Hum Immunol. Jun 2009;70(6):425-9. [Medline].

  5. Bolton WK. Goodpasture''s syndrome. Kidney Int. Nov 1996;50(5):1753-66. [Medline].

  6. Bombassei GJ, Kaplan AA. The association between hydrocarbon exposure and anti-glomerular basement membrane antibody-mediated disease (Goodpasture''s syndrome). Am J Ind Med. 1992;21(2):141-53. [Medline].

  7. Collard HR, Schwarz MI. Diffuse alveolar hemorrhage. Clin Chest Med. Sep 2004;25(3):583-92, vii.

  8. Donaghy M, Rees AJ. Cigarette smoking and lung haemorrhage in glomerulonephritis caused by autoantibodies to glomerular basement membrane. Lancet. Dec 17 1983;2(8364):1390-3. [Medline].

  9. Frankel SK, Cosgrove GP, Fischer A. Update in the diagnosis and management of pulmonary vasculitis. Chest. Feb 2006;129(2):452-65.

  10. Jara LJ, Vera-Lastra O, Calleja MC. Pulmonary-renal vasculitic disorders: differential diagnosis and management. Curr Rheumatol Rep. Apr 2003;5(2):107-15. [Medline].

  11. Jayne DR, Marshall PD, Jones SJ. Autoantibodies to GBM and neutrophil cytoplasm in rapidly progressive glomerulonephritis. Kidney Int. Mar 1990;37(3):965-70. [Medline].

  12. Kluth DC, Rees AJ. Anti-glomerular basement membrane disease. J Am Soc Nephrol. Nov 1999;10(11):2446-53. [Medline].

  13. Lockwood CM, Rees AJ, Pearson TA. Immunosuppression and plasma-exchange in the treatment of Goodpasture''s syndrome. Lancet. Apr 3 1976;1(7962):711-5. [Medline].

  14. Madore F, Lazarus JM, Brady HR. Therapeutic plasma exchange in renal diseases. J Am Soc Nephrol. Mar 1996;7(3):367-86. [Medline].

  15. Mehler PS, Brunvand MW, Hutt MP. Chronic recurrent Goodpasture''s syndrome. Am J Med. Apr 1987;82(4):833-5. [Medline].

  16. Mokrzycki MH, Kaplan AA. Therapeutic plasma exchange: complications and management. Am J Kidney Dis. Jun 1994;23(6):817-27. [Medline].

  17. Rutgers A, Slot M, van Paassen P. Coexistence of anti-glomerular basement membrane antibodies and myeloperoxidase-ANCAs in crescentic glomerulonephritis. Am J Kidney Dis. Aug 2005;46(2):253-62.

  18. Savage CO, Pusey CD, Bowman C. Antiglomerular basement membrane antibody mediated disease in the British Isles 1980-4. Br Med J (Clin Res Ed). Feb 1 1986;292(6516):301-4. [Medline].

  19. Shah MK, Hugghins SY. Characteristics and outcomes of patients with Goodpasture''s syndrome. South Med J. Dec 2002;95(12):1411-8. [Medline].

  20. Sinico RA, Radice A, Corace C. Anti-glomerular basement membrane antibodies in the diagnosis of Goodpasture syndrome: a comparison of different assays. Nephrol Dial Transplant. Feb 2006;21(2):397-401.

  21. Sutton DM, Nair RC, Rock G. Complications of plasma exchange. Transfusion. Feb 1989;29(2):124-7. [Medline].

  22. Weber MF, Andrassy K, Pullig O. Antineutrophil-cytoplasmic antibodies and antiglomerular basement membrane antibodies in Goodpasture''s syndrome and in Wegener''s granulomatosis. J Am Soc Nephrol. Jan 1992;2(7):1227-34. [Medline].

[ CLOSE WINDOW ]

Keywords

Goodpasture syndrome, Goodpasture's syndrome, glomerulonephritis, Goodpasture's disease, type IV collagen, pulmonary hemorrhage, human leukocyte antigen, glomerular basement membrane, , , anti-glomerular basement membrane disease, anti-GBM disease, end-stage renal disease, ESRD, circulating antiglomerular basement membrane antibodies

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Frazier T Stevenson, MD, Associate Professor of Clinical Medicine and Director of Education Development, University of California Davis School of Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
Disclosure: Nothing to disclose.

Mauro Verrelli, MD, FRCP(C), FACP, Assistant Professor, Department of Medicine, Section of Nephrology, University of Manitoba, Canada
Mauro Verrelli, MD, FRCP(C), FACP is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Society of Nephrology, Canadian Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

James W Lohr, MD, Fellowship Program Director, Professor, Department of Internal Medicine, Division of Nephrology, State University of New York at Buffalo
James W Lohr, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, and Central Society for Clinical Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eleanor Lederer, MD, Consulting Staff, Louisville VA Hospital; Professor of Medicine; Interim Chief of Nephrology; Director of Nephrology Training Program; Director, Metabolic Stone Clinic; Director of Outpatient Clinics, Kidney Disease Program, University of Louisville School of Medicine
Eleanor Lederer, MD is a member of the following medical societies: American Association for the Advancement of Science, American Federation for Medical Research, American Society for Biochemistry and Molecular Biology, American Society for Bone and Mineral Research, American Society of Nephrology, American Society of Transplantation, International Society of Nephrology, Kentucky Medical Association, National Kidney Foundation, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Rebecca J Schmidt, DO, FACP, FASN, Professor of Medicine, Section Chief, Department of Medicine, Section of Nephrology, West Virginia University School of Medicine
Rebecca J Schmidt, DO, FACP, FASN is a member of the following medical societies: American College of Osteopathic Internists, American College of Physicians, American Medical Association, American Society of Nephrology, International Society of Nephrology, National Kidney Foundation, Renal Physicians Association, and West Virginia State Medical Association
Disclosure: Abbott Grant/research funds Speaking and teaching; Genzyme Honoraria Consulting; Amgen Honoraria Speaking and teaching; Ortho Biotech Honoraria Speaking and teaching

Chief Editor

Vecihi Batuman, MD, FACP, FASN, Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System
Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.