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Goodpasture's Syndrome: Diagnosis by Transbronchial Lung Biopsy

RAJA T. ABBOUD, M.D., F.R.C.P.(C); WILLIAM H. CHASE, M.D., F.R.C.P.(C); HENRY S. BALLON, M.D., F.R.C.P.(C); STEFAN GRZYBOWSKI, M.D., F.R.C.P.(C); and ALEXANDER MAGIL, M.D., F.R.C.P.(C)
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▸Requests for reprints should be addressed to R.T. Abboud, M.D.; Respiratory Service, Vancouver General Hospital; Vancouver, BC V5Z 1M9, Canada.


Vancouver, Canada


Ann Intern Med. 1978;89(5_Part_1):635-638. doi:10.7326/0003-4819-89-5-635
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A 28-year-old man developed recurrent hemoptyses, breathlessness, anemia, and bilateral pulmonary infiltrates after mild smoke inhalation. He had no laboratory evidence of kidney involvement. Transbronchial lung biopsy showed erythrocytes, iron-containing macrophages within alveolar spaces, normal basement membranes, and strongly positive linear staining of alveolar septa for immunoglobulin G (IgG). Serum antiglomerular basement-membrane antibody was strongly positive by radioimmunoassay. Kidney biopsy showed normal findings by light and electron microscopy but strongly positive linear staining of glomerular capillaries for IgG. Follow-up 9 months later while the patient was taking prednisone revealed no clinical evidence of pulmonary or renal disease. This case shows that immunopathologic study of transbronchial lung biopsies is helpful in differentiating between Goodpasture's syndrome and idiopathic pulmonary hemosiderosis, while the absence of clinical and microscopic evidence of kidney disease does not exclude Goodpasture's syndrome.

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[A case of Goodpasture's syndrome with IgA antibasement membrane antibody]. Nihon Kyobu Shikkan Gakkai Zasshi 1990;28(4):634-8.
[Double filtration plasmapheresis in case of Goodpasture's syndrome]. Nihon Kyobu Shikkan Gakkai Zasshi 1990;28(4):628-33.
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