Goodpasture disease

Last reviewed: 27 Apr 2022
Last updated: 06 Aug 2019

Summary

Definition

History and exam

Key diagnostic factors

  • reduced urine output
  • hemoptysis
  • edema
More key diagnostic factors

Other diagnostic factors

  • male gender
  • age 20 to 30 years or 60 to 70 years
  • shortness of breath
  • cough
  • fever
  • nausea
  • crackles on lung examination
Other diagnostic factors

Risk factors

  • HLA-DRB1 or DR4
More risk factors

Diagnostic investigations

1st investigations to order

  • renal function testing
  • renal biopsy
  • antiglomerular basement membrane (anti-GBM) antibody titer
  • antineutrophil cytoplasmic antibodies (ANCA)
  • serum complement (C3 and C4)
  • antinuclear antibody
  • cryoglobulins
  • hepatitis panel
  • antistreptolysin O titer
  • clotting screen
More 1st investigations to order

Treatment algorithm

INITIAL

reversible renal disease or any pulmonary involvement

irreversible renal disease

Contributors

Authors

Richard G. Phelps, BChir

Senior Lecturer and Honorary Consultant in Nephrology

University of Edinburgh and Edinburgh Royal Infirmary

Edinburgh

UK

Disclosures

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

Acknowledgements

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

Nashville

TN

Disclosures

DBB declares that she has no competing interests.

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