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GOODPASTURE SYNDROME

“ Autoimmune disease characterised by glomerulonephritis and pulmonary haemorrhage —note that pulmonary features occur before renal manifest...

Autoimmune disease characterised by glomerulonephritis and pulmonary haemorrhage—note that pulmonary features occur before renal manifestations. The pathology is antiglomerular basement membrane antibodies; these attack the alveolar basement membrane in the lung. Associated with a positive p-ANCA (anti-neutrophil cytoplasmic antibody) or c-ANCA in about 30%.
PLAIN FILM
•  Bilateral consolidation with sparing of the costophrenic angles and lung periphery.
•  Progression to an interstitial/fibrotic pattern in chronic disease.
HRCT
•  Patchy ground-glass opacification with peripheral and costophrenic angle sparing.
•  Airspace disease clears within a couple of weeks.
•  Pulmonary fibrosis may develop in the long term.