Last reviewed: June 2019
Last updated: September  2017



History and exam

Key diagnostic factors

  • reduced urine output
  • haemoptysis
  • oedema

Other diagnostic factors

  • male sex
  • age 20 to 30 years or 60 to 70 years
  • recent URTI
  • shortness of breath
  • cough
  • fever
  • nausea
  • crackles on lung examination

Risk factors

  • HLA-DRB1 or DR4

Diagnostic investigations

1st investigations to order

  • renal function testing
  • renal biopsy
  • anti-glomerular basement membrane (anti-GBM) antibody titre
  • anti-neutrophil cytoplasmic antibodies (ANCA)
  • serum complement (C3 and C4)
  • ANA
  • cryoglobulins
  • hepatitis panel
  • anti-streptolysin O titre
  • clotting screen
Full details

Treatment algorithm


Authors VIEW ALL

Senior Lecturer and Honorary Consultant in Nephrology

University of Edinburgh and Edinburgh Royal Infirmary




RGP declares that he has no competing interests.

Dr Richard G. Phelps would like to gratefully acknowledge Professor Andre A. Kaplan and Dr Michael S. Gersch, previous contributors to this monograph. AAK has received honoraria in 2013 to speak about plasma exchange from Gambro and Alexion (Gambro manufactures products for plasma exchange and Alexion manufactures a complement cascade inhibitor). MSG declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor of Medicine

Division of Nephrology

Department of Medicine

Vanderbilt University School of Medicine




DBB declares that she has no competing interests.

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