Encyclopedia of Health and Medicine

Goodpasture’s syndrome 193
See also GLOMERULONEPHRITIS; MEDICARE COVER-
AGE FOR PERMANENT RENAL FAILURE; NEPHROTIC SYN-
DROME.
glomerulus The coiled capillary network within
the NEPHRON of the kidney through which BLOOD
passes for filtration. Glomeruli are abundant
within the KIDNEYS as each kidney contains more
than a million nephrons. The walls of the
glomerulus are only a few cells in thickness. The
glomerular walls are semipermeable, allowing
smaller molecules such as water, metabolic wastes,
GLUCOSE, and electrolytes to pass through and collect
in the capsule (called Bowman’s capsule) that
surrounds the glomerulus. Together the glomerulus
and Bowman’s capsule are the renal corpuscle.
The fluid and its contents, called filtrate, passes
into the tubules of the nephron, which further filter
and concentrate the filtrate. The nephron
eventually reabsorbs 99 percent of the filtrate back
into the blood; the remaining fluid drains into collecting
ducts to move out of the kidneys as URINE.
The glomerular filtration rate (GFR) is an important
measure of kidney function. The GFR of a
healthy adult kidney is 125 milliliters per minute.
For further discussion of the glomerulus within
the context of the urinary system’s structure and
function please see the overview section “The Urinary
System.”
See also GLOMERULONEPHRITIS; GLOMERULOSCLERO-
SIS; RENAL FAILURE.
Goodpasture’s syndrome An autoimmune disorder
in which the IMMUNE SYSTEM produces antibodies
that attack the glomeruli in the KIDNEYS,
impairing kidney function, and the alveoli in the
LUNGS, causing bleeding into the lung tissue. In
most people who develop Goodpasture’s syndrome
the symptoms follow a viral INFECTION of
the upper respiratory tract or exposure to environmental
toxins, notably hydrocarbons. Because
Goodpasture’s syndrome tends to run in families,
researchers believe a GENE MUTATION is likely
responsible.
Siphoning gasoline and sniffing aerosols
such as paints and glues are the most
common exposures to hydrocarbons
that can result in Goodpasture’s syndrome.
Though the coughing up of bloody SPUTUM
(HEMOPTYSIS) is the first and often the more distressing
sign of Goodpasture’s syndrome, GLOMERU-
LONEPHRITIS is the more serious consequence,
leading rapidly in many people to RENAL FAILURE.
ANEMIA (insufficient erythrocytes in the blood)
and HYPERTENSION (elevated BLOOD PRESSURE), consequences
of the renal failure, may quickly become
significant.
SYMPTOMS OF GOODPASTURE’S SYNDROME
Pulmonary (Lungs)
HEMOPTYSIS (bloody SPUTUM)
DYSPNEA (shortness of breath)
COUGH
CHEST PAIN
Renal (Kidneys)
HEMATURIA (bloody URINE)
foamy urine (indicates
ALBUMINURIA)
decreased urine volume
edema (fluid retention)
The diagnostic path includes blood and urine
tests to assess kidney function, chest X-RAY to
detect accumulated fluid in the lungs, and biopsy
of lung and kidney tissue to confirm the presence
of antibodies. The course of Goodpasture’s syndrome
may run two months to several years.
Early diagnosis allows aggressive interventions,
including plasmapheresis to remove antibodies
from the bloodstream and IMMUNOSUPPRESSIVE THER-
APY to prevent the immune system from producing
further antibodies. These interventions can mediate
the syndrome’s progression, minimizing damage
to the kidneys. Though about 90 percent of
those who develop this once-fatal syndrome now
survive, many of them continue to experience
progressive renal failure that results in END-STAGE
RENAL DISEASE (ESRD).
See also ALVEOLUS; ANTIBODY; AUTOIMMUNE DISOR-
DERS; HEMAPHERESIS; GLOMERULUS; RENIN.