What is Goodpasture Syndrome?

Goodpasture syndrome is also known as anti-glomerular basement membrane (anti-GBM) disease. This is because antibodies (proteins made by the immune system to protect the body from potentially harmful invaders) target part of the microscopic lining between cells in the kidneys and lungs which is called the basement membrane. This can lead to severe kidney and lung damage.

Normally, the immune system acts against infections such as bacteria and viruses, but in Goodpasture syndrome, it acts against healthy tissues too. This is called an autoimmune disease.

Signs and symptoms of Goodpasture syndrome

Symptoms of Goodpasture syndrome vary and depend on which parts of the body are being damaged by the immune system.

General symptoms that can appear before or with kidney and lung symptoms include:

Feeling tired, weak and general discomfort

Anaemia which can develop due to ongoing bleeding in the lungs

Feeling and/or being sick

Kidney-related symptoms can include:

Blood in the urine

Protein in the urine (proteinuria)

Reduced volume of urine

Fluid build-up, which can cause swelling in your legs and feet

High blood pressure

Kidney failure may occur in serious cases.

Lung related symptoms can include:

Coughing up blood

Shortness of breath

Chest pain

Dry cough

Severe lung bleeding can lead to respiratory failure.

Certain environmental factors can increase the risk of Goodpasture syndrome, such as smoking, breathing in metal dust or certain chemicals found in petroleum products (for example fuel, paint thinner, furniture polish), infections, certain drugs and medications.

How is Goodpasture syndrome diagnosed?

A range of tests can be used to diagnose Goodpasture syndrome:

Blood tests can detect harmful antibodies attacking your lungs and kidneys and can also be used to calculate your eGFR to indicate how well your kidneys are working.

Urine tests to check for protein and blood; both of which can be signs of kidney damage.

A small sample of kidney tissue (called a kidney biopsy) may be tested to look for harmful antibodies and signs of kidney damage.

Chest X-rays can also help to identify lung damage.

Goodpasture syndrome treatments

Early and effective treatment is important to try and prevent serious long-term damage to the kidneys and lungs. Options for this include:

Immunosuppressant medications, such as prednisone, to reduce the strength of the immune system response.

Plasmapheresis (plasma exchange), a process where harmful antibodies are removed from the blood via an external filtering system.

Dialysis and oxygen may also be used to support kidney and lung function.

Goodpasture syndrome prognosis

Long-term outcomes for Goodpasture syndrome depend upon how early treatment is started and how well the individual responds. Although many patients recover well, others can progress to kidney failure or have severe lung damage that needs treatment.