Goodpasture Syndrome, Pulmonary

Idiopathic recurrent alveolar hemorrhage and rapidly progressive glomerulonephritis

Mediated by anti-glomerular basement membrane antibodies

Occurs mainly in men who are in their 30s and 40s

Hemoptysis is the usual presenting symptom

However, pulmonary hemorrhage may be occult

Dyspnea, cough, hypoxemia, and diffuse bilateral alveolar infiltrates are typical features

Iron deficiency anemia and microscopic hematuria are usually present

Based on characteristic linear IgG deposits detected by immunofluorescence in glomeruli or alveoli and on the presence of anti-glomerular basement membrane antibody in serum

Combinations of immunosuppressive drugs (initially methylprednisolone, 30 mg/kg intravenously over 20 minutes every other day for three doses, followed by daily oral prednisone, 1 mg/kg/day; with cyclophosphamide, 2 mg/kg by mouth per day) and plasmapheresis have yielded excellent results