Goodpasture syndrome laboratory findings: Difference between revisions
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Laboratory findings consistent with the diagnosis of Goodpasture syndrome include, anti-glomerular basement membrane antibodies, 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, anti-glomerular basement membrane antibodies, 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: | ||
===Blood Work-up===<ref name="pmid25462583">{{cite journal| author=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G et al.| title=Goodpasture's syndrome: a clinical update. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 3 | pages= 246-53 | pmid=25462583 | doi=10.1016/j.autrev.2014.11.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25462583 }} </ref> | ===Blood Work-up=== <ref name="pmid25462583">{{cite journal| author=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G et al.| title=Goodpasture's syndrome: a clinical update. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 3 | pages= 246-53 | pmid=25462583 | doi=10.1016/j.autrev.2014.11.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25462583 }} </ref> | ||
* Complete blood count (CBC) | * Complete blood count (CBC) | ||
* Uremia | * Uremia | ||
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===Renal Biopsy=== | ===Renal Biopsy=== | ||
Renal biopsy is the gold standard in establishing Goodpasture syndrome.<ref name="pmid22218111">{{cite journal| author=Alenzi FQ, Salem ML, Alenazi FA, Wyse RK| title=Cellular and molecular aspects of Goodpasture syndrome. | journal=Iran J Kidney Dis | year= 2012 | volume= 6 | issue= 1 | pages= 1-8 | pmid=22218111 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22218111 }} </ref> 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. <ref name="pmid12815141">{{cite journal| author=Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG| title=Alport's syndrome, Goodpasture's syndrome, and type IV collagen. | journal=N Engl J Med | year= 2003 | volume= 348 | issue= 25 | pages= 2543-56 | pmid=12815141 | doi=10.1056/NEJMra022296 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12815141 }}</ref> 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.<ref name="pmid25462583">{{cite journal| author=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G et al.| title=Goodpasture's syndrome: a clinical update. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 3 | pages= 246-53 | pmid=25462583 | doi=10.1016/j.autrev.2014.11.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25462583 }}</ref> | Renal biopsy is the gold standard in establishing Goodpasture syndrome.<ref name="pmid22218111">{{cite journal| author=Alenzi FQ, Salem ML, Alenazi FA, Wyse RK| title=Cellular and molecular aspects of Goodpasture syndrome. | journal=Iran J Kidney Dis | year= 2012 | volume= 6 | issue= 1 | pages= 1-8 | pmid=22218111 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22218111 }} </ref> 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. <ref name="pmid12815141">{{cite journal| author=Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG| title=Alport's syndrome, Goodpasture's syndrome, and type IV collagen. | journal=N Engl J Med | year= 2003 | volume= 348 | issue= 25 | pages= 2543-56 | pmid=12815141 | doi=10.1056/NEJMra022296 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12815141 }}</ref> 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.<ref name="pmid25462583">{{cite journal| author=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G et al.| title=Goodpasture's syndrome: a clinical update. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 3 | pages= 246-53 | pmid=25462583 | doi=10.1016/j.autrev.2014.11.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25462583 }}</ref> | ||
==References== | ==References== | ||
Revision as of 15:10, 4 November 2016
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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]
Overview
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include, anti-glomerular basement membrane antibodies elevated blood urea nitrogen, low-grade proteinuria, leukocytosis, gross or microscopic hematuria, and red cell casts.
Laboratory Findings
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include, anti-glomerular basement membrane antibodies, 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:
===Blood Work-up=== [1]
- Complete blood count (CBC)
- Uremia
- Serum creatinine
- Blood urea nitrogen (BUN)
- Anti-glomerular basement membrane test
- Anti-neutrophil cytoplasmic antibody test
Urinalysis
- Proteinuria
- Hematuria
- Red cell casts
Renal Biopsy
Renal biopsy is the gold standard in establishing Goodpasture syndrome.[2] 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. [3] 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.[1]
References
- ↑ 1.0 1.1 Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G; et al. (2015). "Goodpasture's syndrome: a clinical update". Autoimmun Rev. 14 (3): 246–53. doi:10.1016/j.autrev.2014.11.006. PMID 25462583.
- ↑ Alenzi FQ, Salem ML, Alenazi FA, Wyse RK (2012). "Cellular and molecular aspects of Goodpasture syndrome". Iran J Kidney Dis. 6 (1): 1–8. PMID 22218111.
- ↑ Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG (2003). "Alport's syndrome, Goodpasture's syndrome, and type IV collagen". N Engl J Med. 348 (25): 2543–56. doi:10.1056/NEJMra022296. PMID 12815141.