A 22-year-old female, a smoker, with a short history of respiratory tract infection presents to the emergency with multiple episodes of frank hemoptysis. Following lab results are obtained: S. creatinine 4.5, S. BUN 45, microscopic hematuria and USG findings of enlarged kidneys.
What is the diagnosis following the CT scan?
Which blood test is required to confirm this?
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CT shows presence of extensive bilateral alveolar exudates (hemorrhage). In view of USG findings, the diagnosis of pulmonary-renal syndrome is suggested, with a possibility of Goodpasture's disease or an unusual presentation of Wegener's or other forms of vasculitis. Anti-GBM antibody titer was strongly positive in this patient confirming the diagnosis of Goodpasture's syndrome.
Pulmonary-renal syndrome is a broad category that includes Goodpasture's syndrome, systemic vasculitis, Wegener's granulomatosis, polyarteritis nodosa, and systemic lupus erythematosus.
is a rare autoimmune disorder characterized by pulmonary hemorrhage, rapidly
progressing glomerulonephritis, and antiglomerular basement membrane (GBM)
Nikhil Cunha, Bandra Holy Family Hospital, Mumbai