Characteristics and outcomes of patients with Goodpasture's syndrome.

BACKGROUND: Goodpasture's syndrome is a rare disorder characterized by pulmonary hemorrhage, glomerulonephritis, and antiglomerular basement membrane antibodies.

METHODS: Case reports of Goodpasture's syndrome between 1993 and 2000 were identified using MEDLINE. Each case was reviewed for clinical manifestations, laboratory features, pathophysiology, treatment options, and outcomes.

RESULTS: Eighty-five cases of Goodpasture's syndrome were reported in the English language literature. The mean age of patients in this review was 44 years. Most patients had multiple risk factors. Smoking was strongly associated with pulmonary hemorrhage. Most patients presented with hemoptysis and crackles. More than 90% had antiglomerular basement membrane antibodies, and 80% had crescenteric glomerulonephritis on renal biopsy.

CONCLUSION: Most patients were treated with immunosuppression and plasma exchange and were alive at follow-up. Patients with either pulmonary or renal signs and symptoms should be evaluated for Goodpasture's syndrome, since early diagnosis allows prompt treatment and improved outcome.