Goodpasture's Syndrome

Kidney Health Care - David Mangusan Jr, PTRP

Also called anti-glomerular basement antibody disease, Goodpasture’s syndrome is a rare disease that can affect the lungs and kidneys. The condition is a type of an autoimmune disease in which the body’s immune system attacks the body’s normal tissues.

Normally, the immune system creates antibodies to fight off germs or other infections. In Goodpasture’s syndrome, however, the immune system makes antibodies that attack the lungs and kidneys. The reason why this happens is not fully known. Researchers have identified possible causes, which include
 Presence of an inherited component
 Exposure to certain chemicals, including hydrocarbon solvents and Paraquat (a weed killer)
 Viral infections
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Symptoms

Goodpasture’s syndrome may cause people to cough up blood. Bleeding in the lungs can be very serious or even fatal in some cases. However, Goodpasture’s syndrome does not usually lead to permanent lung damage.

Depending on what organ the condition affects, first signs may be vague, such as
 Fatigue

 Paleness

 Nausea

 Difficulty breathing
These signs may be followed by kidney involvement. Signs or symptoms of kidney damage may include
 Blood in the urine (hematuria)

 Protein in the urine (proteinuria)

 Swelling

 Burning sensation while urinating
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Diagnosis

To diagnose Goodpasture’s syndrome, doctors use a blood test, but a kidney or lung biopsy may be necessary to check for the presence of harmful antibodies. In biopsy, a needle is used to extract small samples of kidney or lung tissue for examination under a microscope.

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Treatment

Treatment of Goodpasture’s syndrome may include the use of immunosuppressive drugs and plasmapheresis.
 Oral immunosuppressive drugs such as cyclophosphamide and corticosteroids are used to keep the immune system from making antibodies.

 Corticosteroid drugs may be given intravenously to control bleeding in the lungs.

 Plasmapheresis. This procedure may be helpful and necessary to remove harmful antibodies from the blood. This process involves drawing blood from the patient, about 300 ml at a time, and is placed in a centrifuge to separate the red and white blood cells from the blood plasma. The cells without the plasma are then placed in a plasma substitute and returned to the body. Usually, this procedure is done in combination with immunosuppressive drug treatment.
Goodpasture’s syndrome may last only a few days or as long as 2 years. When it causes damage to the kidneys, it may be long-lasting. If the kidneys totally fail to work, dialysis or kidney transplantation may become necessary. Dialysis is a procedure done to remove waste products and extra fluid from the blood.

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More Information About Goodpasture’s Syndrome:

American Kidney Fund
Internet: www.kidneyfund.org

National Kidney and Urologic Diseases Information Clearinghouse
Internet: http://kidney.niddk.nih.gov

National Kidney Foundation
Internet: www.kidney.org

Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Goodpasture’s Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-4558, April 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/goodpasture/index.htm


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