Goodpasture syndrome laboratory findings

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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, 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 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:

Blood Work-up

• 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 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.