Last reviewed: 28 Sep 2021
Last updated: 06 Aug 2019



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
  • shortness of breath
  • cough
  • fever
  • nausea
  • crackles on lung examination

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)
  • antinuclear antibody
  • cryoglobulins
  • hepatitis panel
  • anti-streptolysin O titre
  • clotting screen

Treatment algorithm



Richard G. Phelps, BChir

Senior Lecturer and Honorary Consultant in Nephrology

University of Edinburgh and Edinburgh Royal Infirmary




RGP has helped Genzyme develop educational materials for neurologists regarding the increased risk of Goodpasture's disease with alemtuzumab use. RGP has published an article on post-alemtuzumab nephritis in which employees of Genzyme were co-authors.


Dr Richard G. Phelps would like to gratefully acknowledge Professor Andre A. Kaplan and Dr Michael S. Gersch, previous contributors to this topic. 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

Dorin-Bogdan Borza, PhD

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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