Goodpasture syndrome history and symptoms
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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
Obtaining a complete history is an important aspect of making a diagnosis of Goodpasture syndrome, as it can provide insight into cause, precipitating factors, and associated underlying conditions. Symptoms may develop acutely or rapidly affecting the renal and pulmonary system. Symptoms of Goodpasture syndrome include, malaise, pyrexia and chills and arthralgia, fatigue, lethargy, pallor, and anorexia.[1]
History and Symptoms
Symptoms may occur very slowly over months or even years, but they often develop quickly over days to weeks.
Loss of appetite, fatigue, weakness are often seen at first.[1] [2]
Pulmonary symptoms may include:[1]
- Hemoptysis
- Dry cough
- Dyspnea
- Anemia
- Pulmonary hemorrhage that may lead to respiratory failure
- less frequently may cause angina pectoris
Renal and other symptoms include:[1]
- Dysuria
- Hematuria
- Edema of the hands and feet
- Uremia
- Hypertension
- Back pain below the ribs
- Hearing loss
- Vertigo
Lung disease
Lung damage may cause nothing more serious than a dry cough and minor breathlessness and such mild symptoms may last for many years before more severe ones develop. At its most serious, however, lung damage may cause severe impairment of oxygenation so that intensive care is required. Deterioration between the two extremes may occur very rapidly, often at the same time as rapid deterioration in the kidney. The patient often does not seek medical attention until he or she begins coughing up blood (hemoptysis). The patient may be anemic due to loss of blood through lung haemorrhaging over a long period. In Goodpasture’s syndrome, unlike many other conditions that cause similar symptoms, lung hemorrhaging most often occurs in smokers and those with damage from lung infection or exposure to fumes.
Kidney disease
The kidney disease mostly affects the glomeruli causing a form of nephritis. It is usually not detected until a rapid advance of the disease occurs so that kidney function can be completely lost in a matter of days, a condition known as rapidly progressive glomerulonephritis, or RPGN. Blood leaks into the urine causing hematuria, the volume urinated decreases and urea and other products usually excreted by the kidney are retained and build up in the blood. This is acute renal failure. Renal failure does not cause symptoms until more than 80% of kidney function has been lost. Symptoms include loss of appetite and sickness at first and then, when the damage is more advanced, breathlessness, high blood pressure and edema (swelling caused by fluid retention). The kidney involvement usually presents as nephritic syndrome, i.e. hematuria, a reduced glomerular filtration rate, and high blood pressure. This is in contrast to nephrotic syndrome, a more rare outcome of Goodpasture's, characterized by an abnormally large amount protein in the urine (proteinuria), coupled with severe edema.
References
- ↑ 1.0 1.1 1.2 1.3 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.
- ↑ Hellmark T, Segelmark M (2014). "Diagnosis and classification of Goodpasture's disease (anti-GBM)". J Autoimmun. 48-49: 108–12. doi:10.1016/j.jaut.2014.01.024. PMID 24456936.