Glomerular basement membrane thinning in a patient with hematuria and hemoptysis mimicking Goodpasture’s syndrome

Mark Coleman, John W. Stirling, Leonie R. Langford, Peter A. Frith, Lindsay J. Barratt

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3 Citations (Scopus)

Abstract

Ultrastructural morphometric studies of glomerular basement membrane (GBM) thickness are described in two renal biopsy specimens from a patient who presented with hemoptysis and hematuria mimicking Goodpasture’s syn-drome. Significant GBM abnormality, with attenuation as the main lesion, identified in a biopsy specimen taken during active clinical disease appeared to have resolved in a second biopsy specimen taken during the recovery phase. There was no evidence of glomerulonephritis. Concurrent lung biopsy studies showed focal alveolar-capillary wall basal lamina changes of uncertain diagnostic significance. These observations suggest the alternative possibilities that GBM attenuation may be either an acquired consequence of systemic disease or may be part of an hitherto unrecognized primary multisystem abnormality of basal lamina affecting, in this case, glomerular and pulmonary laminae, resulting in hematuria and hemoptysis. The morphometric studies in this case indicate that simple-mean measurements of GBM thickness are inadequate alone for the quantitative study of this lamina because significant inter- and intraglomerular membrane variation, if irregularly distributed, can remain undetected.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalAmerican Journal of Nephrology
Volume14
Issue number1
DOIs
Publication statusPublished - 1994
Externally publishedYes

Keywords

  • Alveolar hemorrhage
  • Glomerular basement membrane thinning
  • Goodpasture’s syndrome
  • Hematuria
  • Hemoptysis

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