Melanie B. Peachell, MD; Nestor L. Muller, MD, PhD

Disclosures

Semin Respir Crit Care Med. 2004;25(5) 

In This Article

Goodpasture's Syndrome

Goodpasture's syndrome is a pulmonary-renal syndrome characterized by the presence of antiglomerular basement membrane antibodies in the circulation.[38] It affects both the kidneys and the lungs in 60 to 80% of cases, only the kidneys in 20 to 40%, and only the lungs in < 10% of cases.[39] It is seen most commonly in young adults (mean age 35 years) and is more common in males than females.

The radiological manifestations reflect the presence of diffuse pulmonary hemorrhage and consist of patchy or confluent bilateral areas of consolidation.[40] The consolidation can be diffuse but tends to involve mainly the perihilar regions and spare the lung apices and the costophrenic angles.[40,41] Less common findings include ground-glass opacities and migratory areas of consolidation[41] (Fig. 8). The chest radiograph, however, can be normal in the setting of diffuse pulmonary hemorrhage.[40] In one review of 39 patients, Bowley et al found the chest radiograph to be normal in 7 (18%) cases.[40] The CT manifestations of acute pulmonary hemorrhage consist of bilateral ground-glass opacities or areas of consolidation. These can be patchy or diffuse but tend to involve predominantly the dependent lung regions.[41,42]

Goodpasture's syndrome. (A) Computed tomographic (CT) image at the level of the aortic arch shows centrilobular ground-glass opacities throughout the upper lobes due to diffuse pulmonary hemorrhage. (B) CT image at the level of the right main pulmonary artery shows ground-glass opacities in the lower lobes. The patient was a 35-year-old woman.

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