Goodpasture's Syndrome

Autoimmune disorder with antibodies generated to components of the glomerular basement membrane, affecting the kidneys and the lungs

Aetiology

  • Antibodies against alpha-3 subunit of type IV collagen produce a type II hypersensitivity reaction

Predisposing factors

  • Association with HLA-DR2
  • Exposure to organic solvents or hydrocarbons
  • Smoking
  • Infection, e.g. influenza A2
  • Cocaine inhalation
  • Exposure to metal dusts

Clinical presentation

  • Non-specific symptoms - malaise, weight loss, fatigue, fever, chills, arthralgia
  • Lung symptoms - haemoptysis, chest pain, cough, SOB
  • Kidney symptoms - haematuria, proteinuria, oedema, high urea in blood, hypertension

Investigations

  • Bloods - anti-GBM antibodies
  • Renal biopsy - glomerulonephritis

Management

  • Plasmapheresis