Goodpasture Syndrome Differential Diagnoses

Updated: Aug 25, 2016
  • Author: Pranay Kathuria, MD, FACP, FASN, FNKF; Chief Editor: Vecihi Batuman, MD, FASN  more...
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DDx

Diagnostic Considerations

Conditions that affect the lung and kidney (pulmonary-renal syndromes) are important in the differential diagnosis. These include granulomatosis with polyangiitis (Wegener granulomatosis), systemic lupus erythematosus, microscopic polyangiitis, and other forms of systemic vasculitides. Distinguishing granulomatosis with polyangiitis from Goodpasture syndrome is particularly important. Interestingly, some patients with Goodpasture syndrome may present with antineutrophilic cytoplasmic antibodies (ANCAs), which are predominantly observed in patients with granulomatosis with polyangiitis. [17]

Pulmonary-renal syndromes are less commonly a manifestation of IgA-mediated disorders (eg, IgA nephropathy or Henoch-Schönlein purpura) and of immune complex–mediated renal disease (eg, essential mixed cryoglobulinemia). Rarely, rapidly progressive glomerulonephritis alone can cause pulmonary-renal syndromes through a mechanism involving renal failure, volume overload, and pulmonary edema with hemoptysis.

Careful attention to the medical history, physical examination, and targeted laboratory evaluation often suggests the underlying cause. Go to Pediatric Anti-GBM Disease (Goodpasture Syndrome) for complete information on this topic.

Differential Diagnoses