What causes Goodpasture syndrome (anti–glomerular basement membrane disease) (anti-GBM)?

Updated: Dec 16, 2020
  • Author: Pranay Kathuria, MD, FACP, FASN, FNKF; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Like other autoimmune conditions, anti-GBM disease is thought to result from an environmental insult in a person with genetic susceptibility. The human leukocyte antigen (HLA) serotype HLA-DR15 has been strongly asssociated with anti-GBM disease. An initial insult to the pulmonary vasculature is required for exposure of the alveolar capillaries to the anti-GBM antibodies. Environmental factors that may lead to such exposure include the following:

  • Exposure to organic solvents or hydrocarbons
  • Smoking
  • Infection (eg, influenza A2)
  • Cocaine inhalation
  • Exposure to metal dusts
  • Lymphocyte-depletion therapy, such as alemtuzumab
  • Extracorporeal shock wave lithotripsy [15]

COVID-19 has been associated with a cluster of of 8 cases of anti-GBM disease. [16]

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