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Goodpasture's Syndrome
Along with Wegener's Granulomatosis, this disease is the commonest of the Pulmonary-Renal syndromes.
Pathophysiology: Anti-basement membrane antibodies coat the basement membranes of capillaries in the lungs and kidneys leading to friability and bleeding. They have a typical histologic appearance on immuno-staining.
Clinical Clues: hemoptysis, acute dyspnea, oxygen desaturations, hematuria, renal dysfunction.
CXR Findings:
- patchy, confluent, or diffuse airspace disease, often bilateral
- no pleural effusion
- heart size may be normal or enlarged (especially if underlying chronic renal failure)
- no Kerley B lines
Treatment: Aggressive plasmaphoresis and support. Guarded long term prognosis.
"Aunt Sophies": Really any airspace disease: pneumonia, aspiration, hemorrhage, pulmonary edema especially non-cardiac, and tumor especially bronchoalveolar cell carcinoma.
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