Goodpasture's syndrome

• LINEAR IgG deposits on renal biopsy (under IF)
• anti-GBM antibodies against type IV collagen, specifically noncollagenous region of its alpha-3 chain
• type'2' hypersensitivity, '2' main organs (lungs & kidneys),
• male: female (2:1)
• HLA DR2
• bimodal age distribution (peaks in 20-30 and 60-70 age bracket)
• raised TLCO 2º pulm: h'ge

The combination of haemoptysis, renal failure and linear IgG deposits points to a diagnosis of Goodpasture's syndrome.

Anemia is often present from chronic blood loss from hemoptysis

Note difference from Wegener's granulomatosis (WG)

• NO systemic vasculitis; no skin, joint, GI, eye, or CNS involvement;
• No upper respiratory tract involvement
• i.e. Goodpasture is limited to just lungs and kidneys

#OHCM9 p 301

The ANCA-related nephropathies are associated with crescentic glomerulonephritis

DDx of RPGN: crescentic picture

1. Immune complex dz (45% of cases) eg post-infectious, SLE, IgA/HSP