Goodpasture's Syndrome: Diagnosis by Transbronchial Lung Biopsy

Publisher Website
Google Scholar
Abstract
A 28 yr old man developed recurrent hemoptyses, breathlessness, anemia and bilateral pulmonary infiltrates after mild smoke inhalation. He had no laboratory evidence of kidney involvement. Transbronchial lung biopsy showed erythrocytes, Fe-containing macrophages within alveolar spaces, normal basement membranes and strongly positive linear staining of alveolar septa for immunoglobulin G (IgG). Serum antiglomerular basement-membrane antibody was strongly positive by radioimmunoassay. Kidney biopsy showed normal findings by light microscopy and EM but strongly positive linear staining of glomerular capillaries for IgG. Follow-up 9 mo. later while the patient was taking prednisone revealed no clinical evidence of pulmonary or renal disease. Immunopathologic study of transbronchial lung biopsies is apparently helpful in differentiating between Goodpasture''s syndrome and idiopathic pulmonary hemosiderosis, while the absence of clinical and microscopic evidence of kidney disease does not exclude Goodpasture''s syndrome.