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{{Goodpastures syndrome }}
{{Goodpastures syndrome }}
{{CMG}}{{APM}}{{AE}}{{KW}}
{{CMG}}{{APM}}; {{AE}}{{KW}}{{Akshun}}


==Overview==
==Overview==
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include, elevated blood urea nitrogen, low-grade proteinuria, leukocytosis, gross or microscopic hematuria, and red cell casts.
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include presence of [[autoantibodies]] such as [[Anti-glomerular basement membrane antibody|anti-glomerular basement membrane antibodies]]. Other findings associated with [[pulmonary]] and [[renal]] injury include elevated [[blood urea nitrogen]], low-grade [[proteinuria]], gross or [[microscopic hematuria]], and red cell casts.


==Laboratory Findings==
==Laboratory Findings==
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include, anti-glomerular basement membrane test, elevated blood urea nitrogen, low-grade proteinuria, leukocytosis, gross or microscopic hematuria, and red cell casts. If laboratory findings do not show anti-glomerular basement membrane antibodies, a test for anti-neutrophil cytoplasmic antibodies should be made to determine possible cause of ANCA associated vasculitis. Routine laboratory test that may be ordered to help in identifying the cause are:
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include presence of [[autoantibodies]] such as [[Anti-glomerular basement membrane antibody|anti-glomerular basement membrane antibodies.]]<ref name="pmid16234289">{{cite journal |vauthors=Sinico RA, Radice A, Corace C, Sabadini E, Bollini B |title=Anti-glomerular basement membrane antibodies in the diagnosis of Goodpasture syndrome: a comparison of different assays |journal=Nephrol. Dial. Transplant. |volume=21 |issue=2 |pages=397–401 |date=February 2006 |pmid=16234289 |doi=10.1093/ndt/gfi230 |url=}}</ref><ref name="pmid19741587">{{cite journal |vauthors=Zhao J, Cui Z, Yang R, Jia XY, Zhang Y, Zhao MH |title=Anti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severity |journal=Kidney Int. |volume=76 |issue=10 |pages=1108–15 |date=November 2009 |pmid=19741587 |doi=10.1038/ki.2009.348 |url=}}</ref><ref name="pmid19151145">{{cite journal |vauthors=Yang R, Hellmark T, Zhao J, Cui Z, Segelmark M, Zhao MH, Wang HY |title=Levels of epitope-specific autoantibodies correlate with renal damage in anti-GBM disease |journal=Nephrol. Dial. Transplant. |volume=24 |issue=6 |pages=1838–44 |date=June 2009 |pmid=19151145 |doi=10.1093/ndt/gfn761 |url=}}</ref>
 
* Other findings associated with [[pulmonary]] and [[renal injury]] include elevated [[blood urea nitrogen]], low-grade [[proteinuria]], gross or [[microscopic hematuria]], and red cell casts.  
===Blood Work-up===
* If laboratory test cannot detect the presence of [[Anti-glomerular basement membrane antibody|anti-glomerular basement membrane antibodies]], other tests such as [[Anti-neutrophil cytoplasmic antibody|anti-neutrophil cytoplasmic antibodies]] ([[ANCA]]) should be done to determine and rule out the presence of [[ANCA]] associated [[vasculitis]].<ref name="pmid1317224">{{cite journal |vauthors=Weber MF, Andrassy K, Pullig O, Koderisch J, Netzer K |title=Antineutrophil-cytoplasmic antibodies and antiglomerular basement membrane antibodies in Goodpasture's syndrome and in Wegener's granulomatosis |journal=J. Am. Soc. Nephrol. |volume=2 |issue=7 |pages=1227–34 |date=January 1992 |pmid=1317224 |doi= |url=}}</ref>
* Complete blood count (CBC)
* Routine laboratory test that may be ordered to help in identifying the cause are:
* Uremia
** [[Complete blood count]] ([[leukocytosis]] and [[anemia]])
* Serum creatinine
** [[Renal function tests|Renal function test]] ([[Blood urea nitrogen|BUN]], [[Serum creatinine|S. creatinine]])
* Blood urea nitrogen (BUN)
** [[Urinalysis]] for [[proteinuria]], [[hematuria]], and red cell casts
* Anti-glomerular basement membrane test
** [[ESR]] and [[CRP]]
* Anti-neutrophil cytoplasmic antibody test
*Pulmonary function testing (PFT) may be done to determine the extent of disease as patients with Goodpasture syndrome tend to have [[interstitial fibrosis]] and a [[Restrictive lung disease|restrictive pattern]] on PFTs.
 
*The diffusing capacity for carbon monoxide ([[DLCO]]) is also elevated due to destruction of [[alveolar]] [[basement membrane]] and subsequent [[fibrosis]].
 
===Urinalysis===
* Proteinuria
* Hematuria
* Red cell casts
 
===Renal Biopsy===
Renal biopsy is the method of choice in determining Goodpasture syndrome. As it can help establish the detection of circulating anti-glomerular basement membrane antibodies. It is of note that a renal biopsy is best over a pulmonary biopsy because of abundance of autofluorecene. Renal biopsy reveals early focal proliferative changes that present with necrosis, crescent formation, and inflammation of the interstitial under light microscopy. Under direct immunofluorescence, linear immunoglobulin G (IgG) deposits are seen encompassing the glomerular basement membrane and at times the distal tubular portion.  
 
 
 
 
 


==References==
==References==

Latest revision as of 14:38, 19 July 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]; Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3] Akshun Kalia M.B.B.S.[4]

Overview

Laboratory findings consistent with the diagnosis of Goodpasture syndrome include presence of autoantibodies such as anti-glomerular basement membrane antibodies. Other findings associated with pulmonary and renal injury include elevated blood urea nitrogen, low-grade proteinuria, gross or microscopic hematuria, and red cell casts.

Laboratory Findings

Laboratory findings consistent with the diagnosis of Goodpasture syndrome include presence of autoantibodies such as anti-glomerular basement membrane antibodies.[1][2][3]

References

  1. Sinico RA, Radice A, Corace C, Sabadini E, Bollini B (February 2006). "Anti-glomerular basement membrane antibodies in the diagnosis of Goodpasture syndrome: a comparison of different assays". Nephrol. Dial. Transplant. 21 (2): 397–401. doi:10.1093/ndt/gfi230. PMID 16234289.
  2. Zhao J, Cui Z, Yang R, Jia XY, Zhang Y, Zhao MH (November 2009). "Anti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severity". Kidney Int. 76 (10): 1108–15. doi:10.1038/ki.2009.348. PMID 19741587.
  3. Yang R, Hellmark T, Zhao J, Cui Z, Segelmark M, Zhao MH, Wang HY (June 2009). "Levels of epitope-specific autoantibodies correlate with renal damage in anti-GBM disease". Nephrol. Dial. Transplant. 24 (6): 1838–44. doi:10.1093/ndt/gfn761. PMID 19151145.
  4. Weber MF, Andrassy K, Pullig O, Koderisch J, Netzer K (January 1992). "Antineutrophil-cytoplasmic antibodies and antiglomerular basement membrane antibodies in Goodpasture's syndrome and in Wegener's granulomatosis". J. Am. Soc. Nephrol. 2 (7): 1227–34. PMID 1317224.

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