What are the key clinical features and laboratory findings that suggest a diagnosis of Goodpasture's syndrome in a patient presenting with pulmonary-r

Key clinical features of Goodpasture's syndrome in a patient presenting with pulmonary-renal syndrome include rapidly progressive glomerulonephritis manifesting as haematuria, proteinuria, and acute kidney injury, alongside pulmonary symptoms such as haemoptysis, dyspnoea, and cough due to pulmonary haemorrhage. Constitutional symptoms like fatigue and malaise may also be present. The combination of these pulmonary and renal manifestations is characteristic of the syndrome NICE CG163 Shah & Hugghins 2002Cui & Zhao 2011Kuang et al. 2024.

Laboratory findings that suggest Goodpasture's syndrome include the presence of circulating anti-glomerular basement membrane (anti-GBM) antibodies detected by ELISA or immunofluorescence, which are highly specific for the disease NICE CG163 Cui & Zhao 2011. Urinalysis typically shows active sediment with red blood cell casts and proteinuria. Renal biopsy reveals crescentic glomerulonephritis with linear IgG deposition along the glomerular basement membrane on immunofluorescence, confirming the diagnosis NICE CG163 Shah & Hugghins 2002Kuang et al. 2024. Pulmonary imaging may show diffuse alveolar infiltrates consistent with pulmonary haemorrhage.

In summary, the diagnosis of Goodpasture's syndrome in pulmonary-renal syndrome is suggested by the clinical triad of rapidly progressive glomerulonephritis, pulmonary haemorrhage, and detection of anti-GBM antibodies, supported by characteristic renal biopsy findings NICE CG163 Shah & Hugghins 2002Cui & Zhao 2011Kuang et al. 2024.