Goodpasture's syndrome

Goodpasture's syndrome is characterised by diffuse alveolar haemorrhage and glomerulitis. Men are commonly affected with most cases occurring between the ages of 20-30 years. It is more likely to occur in smokers. Exposure to smoke and volatile hydrocarbons is associated with initiation as well as exacerbation of the disease. The anti glomerular basement antibody is present in up to 90% of the patients. Renal histology usually shows a focal segmental necrotizing glomerulitis with crescent formation. The TLCO is increased during active bleeding and can be used to monitor the disease. An increase above 30% of baseline is highly suggestive of an intra-alveolar bleed.