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] Akshun Kalia M.B.B.S.[4]
Overview
Laboratory findings consistent with the diagnosis of Goodpasture syndrome include presence of auto-antibodies 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 auto-antibodies 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.
- If laboratory test cannot detect the presence of anti-glomerular basement membrane antibodies, other tests such as anti-neutrophil cytoplasmic antibodies should be done to determine and rule out the presence of ANCA associated vasculitis.
- Routine laboratory test that may be ordered to help in identifying the cause are:
- Complete blood count (CBC)
- Renal function test (BUN, S. creatinine )
- Urinalysis for proteinuria, hematuria, and red cell casts
Renal Biopsy
Renal biopsy is the gold standard in establishing Goodpasture syndrome.[1] 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. [2] 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.[3]
References
- ↑ 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.
- ↑ 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.