Goodpasture Syndrome Clinical Presentation

Updated: Feb 11, 2021
  • Author: Pranay Kathuria, MD, FACP, FASN, FNKF; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Presentation

History

Substantial variation exists in the clinical manifestations of patients with anti–glomerular basement membrane (anti-GBM) disease. From 60-80% of patients have clinically apparent manifestations of pulmonary and renal disease, 20-40% have renal disease alone, and less than 10% have disease that is limited to the lungs.

Symptoms include the following:

  • Constitutional symptoms (eg, malaise, chills and fever, arthralgias) may precede or develop concurrently with pulmonary or renal manifestations

  • Hemoptysis is the presenting sign when the disease affects the lungs. The level of hemoptysis may vary and, in a small percentage of patients, may be absent. Other pulmonary manifestations include cough, dyspnea, and shortness of breath

  • Massive pulmonary hemorrhage leading to respiratory failure may occur

  • Chest pain is present in less than half of the patients

  • Renal manifestations include hematuria, edema, high blood pressure, and eventually uremia

  • Significant anemia may result from persistent intrapulmonary bleeding

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Physical Examination

Physical examination findings in patients with anti-GBM disease include the following:

  • Tachypnea
  • Inspiratory crackles over lung bases
  • Cyanosis
  • Hepatosplenomegaly (may be present)
  • Hypertension (present in 20% of cases)
  • Rash
  • Edema
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