|Values are valid only on day of printing.|
Evaluating patients with rapid onset renal failure or pulmonary hemorrhage, as an aid in the diagnosis of Goodpasture syndrome
Antibodies to glomerular basement membrane (GBM) antigens cause glomerulonephritis, Goodpasture syndrome (glomerulonephritis, often with rapid onset renal failure, and pulmonary hemorrhage), and, less commonly, pulmonary hemosiderosis.(1) Nephrogenic GBM antigens are associated with the noncollagenous carboxyl extension of type IV procollagen. The immunologic stimuli that elicit production of GBM antibodies are not known. There is some evidence of a genetic association with HLA-DR2.
GBM antibody-mediated glomerulonephritis and Goodpasture syndrome occur with a bimodal age distribution primarily in males ages 20 to 40 and in patients older than age 50. Glomerulonephritis without pulmonary involvement is more common in the older age group, and shows a female predominance.
<1.0 U (negative)
> or =1.0 U (positive)
Reference values apply to all ages.
Positive results are consistent with Goodpasture syndrome. Glomerular basement membrane antibodies detected by immunoassay have been reported to be highly specific for Goodpasture syndrome. The sensitivity of this test approaches 87% in untreated patients with systemic disease.(1)
A positive test for glomerular basement membrane (GBM) antibodies cannot be relied upon exclusively to establish the diagnosis of a disease mediated by GBM antibodies. Weakly-positive test results may occur in other immune-mediated diseases, and renal or lung biopsy is often required to establish the diagnosis.
If patient is being evaluated for autoimmune skin disease, order CIFS / Cutaneous Immunofluorescence Antibodies (IgG), Serum for evaluation of anti-intercellular substance (ICS) and antibasement membrane zone (BMZ) antibodies.
1. Pusey CD: Anti-glomerular basement membrane disease. Kidney Int 2003;64:1535-1550