GOODPASTURE'S SYNDROME

Abstract

Summary Nine cases, which show a combination of pulmonary hamorrhage and glomerulonephritis, have been recorded: as the ætiology of the condition is obscure, brevity and precedence are urged to justify the name “Goodpasture's syndrome”. Only twelve other cases could be collected from the literature, but this probably does not reflect its real frequency. The pulmonary lesions appear to be produced by some derangement of the humoral mechanisms of the body, similar to that operating in uncomplicated glomerulonephritis or related conditions, and are distinct and different from the pulmonary changes seen in the lungs in uræmia. The renal lesion is predominantly glomerular and widespread;in most cases, the change is proliferative with hyaline change in the late stages. Active organization with giant‐cell formation is a feature of some cases. The lung changes are characteristically congestion and thickening of alveolar walls with some disintegration and rupture. Alveoli contain a cellular exudate; in later stages organization occurs. Usually the first manifestation of the syndrome is hemoptysis; and as there may be only a trace, or even no albumin in the urine, early diagnosis may be exceedingly difficult. This may influence or mask the real prognosis of the syndrome. As it is a killing disease of young adults, it deserves further study.