Goodpasture syndrome laboratory findings

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 autoantibodies 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 consistent with the diagnosis of Goodpasture syndrome include presence of autoantibodies such as anti-glomerular basement membrane antibodies.^[1]^[2]^[3]

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 (ANCA) should be done to determine and rule out the presence of ANCA associated vasculitis.^[4]
Routine laboratory test that may be ordered to help in identifying the cause are:
- Complete blood count (leukocytosis and anemia)
- Renal function test (BUN, S. creatinine)
- Urinalysis for proteinuria, hematuria, and red cell casts
- ESR and CRP
Pulmonary function testing (PFT) may be done to determine the extent of disease as patients with Goodpasture syndrome tend to have interstitial fibrosis and a restrictive pattern on PFTs.
The diffusing capacity for carbon monoxide (DLCO) is also elevated due to destruction of alveolar basement membrane and subsequent fibrosis.

↑ Sinico RA, Radice A, Corace C, Sabadini E, Bollini B (February 2006). “Anti-glomerular basement membrane antibodies in the diagnosis of Goodpasture syndrome: a comparison of different assays”. Nephrol. Dial. Transplant. 21 (2): 397–401. doi:10.1093/ndt/gfi230. PMID 16234289.
↑ Zhao J, Cui Z, Yang R, Jia XY, Zhang Y, Zhao MH (November 2009). “Anti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severity”. Kidney Int. 76 (10): 1108–15. doi:10.1038/ki.2009.348. PMID 19741587.
↑ Yang R, Hellmark T, Zhao J, Cui Z, Segelmark M, Zhao MH, Wang HY (June 2009). “Levels of epitope-specific autoantibodies correlate with renal damage in anti-GBM disease”. Nephrol. Dial. Transplant. 24 (6): 1838–44. doi:10.1093/ndt/gfn761. PMID 19151145.
↑ Weber MF, Andrassy K, Pullig O, Koderisch J, Netzer K (January 1992). “Antineutrophil-cytoplasmic antibodies and antiglomerular basement membrane antibodies in Goodpasture’s syndrome and in Wegener’s granulomatosis”. J. Am. Soc. Nephrol. 2 (7): 1227–34. PMID 1317224.