Goodpasture Syndrome

Goodpasture syndrome is a rare autoimmune disorder that affects both the lungs and kidneys. The immune system typically makes antibodies to fight off infection. But with Goodpasture syndrome, the immune system mistakenly makes antibodies that attack the lungs and kidneys. This condition can quickly progress to inflammation of the kidneys (glomerulonephritis) and kidney failure. It can be fatal if not quickly diagnosed and treated.

This disease most often occurs in people ages 20 to 30 or those older than age 60. It is more common in men. In some cases, bleeding in the lungs may occur. In most cases, this disease doesn't cause lasting damage to the lungs. But kidney damage may be long-lasting. If the kidneys fail, kidney transplant or dialysis may be needed.

Medical experts are not certain what causes this autoimmune disorder. It can run in families, so genetics may play a role. Or the disease may occur because of a combination of other factors. These include exposure to certain chemicals, such as dry-cleaning chemicals or the weed killer Paraquat. Viral infections, smoking, or medicines may also play a role.

These are the most common symptoms of Goodpasture syndrome:

• Lack of energy or tiring easily (fatigue)
• Nausea
• Trouble breathing
• Pale skin

As the condition progresses, other symptoms may occur, including:

• Coughing up blood
• Burning feeling when urinating

Over time, symptoms of kidney involvement may occur, including:

• Small amounts of blood in the urine (hematuria)
• Protein in the urine (proteinuria)

The symptoms of Goodpasture syndrome may look like other conditions or medical problems. Always see your doctor for a diagnosis.

Your doctor will review your health history and do a physical exam. Other tests include:

• Blood tests. These tests look for high blood levels of waste products that are normally cleared by the kidney into the urine. Circulating antibodies are also found by blood tests.
• Urine tests. Protein may be found in the urine, along with red and white blood cells and groups of cells and cellular material stuck together (granular casts).
• Kidney biopsy. For this test, small tissue samples are removed and looked at under a microscope. You may also have a lung biopsy.
• Chest X-ray. This looks for changes or damage to the lungs.

Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is.

Treatment may include:

• Immunosuppressive medicines. These medicines keep your immune system from making antibodies. They can also put you at greater risk for infections. So you may also be prescribed antibiotics.
• Corticosteroids. These are used to decrease inflammation and tissue damage, which helps control bleeding in your lungs.
• Plasmapheresis. This is a process in which blood plasma is removed and filtered of harmful antibodies, and then returned to your body. It is usually given with steroids.

Even with correct treatment, complications may develop. Your kidney function may decrease to the point of kidney failure. Kidney failure will need treatment, such as dialysis or even a kidney transplant.

If your symptoms get worse or you have new symptoms, let your doctor know right away.

• Goodpasture syndrome is a rare autoimmune disorder in which your body mistakenly makes antibodies that attack the lungs and kidneys.
• It most often occurs in people ages 20 to 30 or older than age 60. It is more common in males.
• It can be fatal if not quickly diagnosed and treated.
• If the kidneys fail, dialysis or kidney transplant will be needed.
• Treatment is aimed at reducing the severity of the symptoms and preventing your immune system from destroying kidney and lung tissue.

Tips to help you get the most from a visit to your doctor:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you.
• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you don't take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your doctor after office hours, including weekends and holidays. This is important if you become ill and you have questions or need advice.