Key diagnostic features:
(1) diffuse pulmonary hemorrhage, which may range from minimal to massive
(2) glomerulonephritis, which is usually is rapidly progressive
(3) presence of anti-glomerular basement antibody (anti-GBM)
Respiratory findings:
(1) cough
(2) dyspnea
(3) hemoptysis
(4) patchy to diffuse changes on chest X-ray
(5) arterial hypoxemia during episodes of pulmonary hemorrhage
(6) decreased diffusing capacity for carbon monoxide
(7) lung biopsies may or may not show IgG deposits along the alveolar basement membrane
Renal findings:
(1) hematuria
(2) red blood cell casts
(3) mild to moderate proteinuria
(4) renal dysfunction may range from minimal to severe at presentation, with most patients progressing to acute renal failure
(5) typically a crescentic glomerulonephritis with linear immunofluorescence on staining for IgG and complement
Other findings:
(1) Iron deficiency anemia if intra-pulmonary hemorrhage is chronic and marked
(2) Some patients may have p-ANCA.
(3) Some patients have arthritic complaints.
