Goodpasture's Syndrome

Goodpasture’s syndrome is associated with

A) Osteoporosis and renal lithiasis
B) Pathologic fractures and thyroiditis
C) Hepatitis and recurrent cystitis
D) Pulmonary hemorrhage and glomerulonephritis
E) Pica and angioedema

Answer and Discussion

The answer is D. (Pulmonary hemorrhage and glomerulonephritis)

Goodpasture’s syndrome is a condition manifested by pulmonary hemorrhages and progressive glomerulonephritis. Circulating basement membrane antibodies are responsible for the renal and pulmonary abnormalities.

Patients with Goodpasture’s syndrome are typically young males (5 to 40 years; male:female ratio of 6:1); however, there is a bimodal peak at approximately 60 years of age. Men and women are equally
affected at older ages.

Symptoms include

• severe hemoptysis, 
• shortness of breath, and 
• renal failure. 

Laboratory findings include iron-deficiency anemia, hematuria, proteinuria, cellular and granular casts in the urine, and circulating antiglomerular antibodies.
Chest radiographs show progressive, bilateral, fluffy infiltrates that may migrate and are asymmetrical.
Renal biopsy may be necessary to make the diagnosis.

Treatment involves highdose steroids, immunosuppression, and plasmapheresis, which may help preserve renal function. If significant injury to the kidneys occurs, then dialysis or transplant may be necessary. Untreated, Goodpasture’s syndrome can be fatal.