Goodpasture syndrome natural history, complications and prognosis

Jump to navigation Jump to search

Goodpasture syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Goodpasture syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Goodpasture syndrome natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Goodpasture syndrome natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Goodpasture syndrome natural history, complications and prognosis

CDC on Goodpasture syndrome natural history, complications and prognosis

Goodpasture syndrome natural history, complications and prognosis in the news

Blogs on Goodpasture syndrome natural history, complications and prognosis

Directions to Hospitals Treating Goodpasture syndrome

Risk calculators and risk factors for Goodpasture syndrome natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]

Overview

If left untreated, Goodpasture syndrome can progress to end stage renal disease and pulmonary failure. Complications of Goodpasture syndrome include, infections, alveolar hemorrhage, end stage renal disease, and pulmonary failure. The prognosis of Goodpasture syndrome is variable, as it depends upon the diagnosis, start of treatment and the level of serum creatinine.

Natural History

If left untreated, Goodpasture syndrome can progress to end stage renal disease and pulmonary failure.

Complications

Possible complications of Goodpasture syndrome include:

  • Infections with P. jiroveci[1]
  • Alveolar hemorrhage[2]
  • End stage renal disease
  • Pulmonary failure

Prognosis

In the past the prognosis of Goodpasture syndrome was fatal.[3] Today, the prognosis of Goodpasture syndrome is heavily dependent on the time of diagnosis, the start of medication, and the level of serum creatinine.[4]

The following are favorable prognostic factors:

  • Aggressive treatment with corticosteroids, plasmapheresis, and immunosuppressants.
  • Serum creatinine of less than 5.7 mg/dL

The following are poor prognostic factors:

  • Serum creatinine that is greater than 5.7 mg/dL
  • Patients who require long term dialysis
  • Glomerular Filtration Rate (GFR) of less than 15 mL/min
  • Advanced age
  • Low hemoglobin
  • High white blood cell count
  • Crescent formation that have extended greater than 80% of glomeruli
  • ANCA and anti-GBM antibodies present together [5]

The current 5 year survival rate of Goodpasture syndrome is greater than 80% and patients requiring long-term renal dialysis less than 30% in advent to earlier diagnosis and aggressive treatment regimen. [6]



  • The overview section should include the disease name in the first sentence.
  • The goal is to summarize the entire page in several sentences. This section can be the same as the natural history, complications and prognosis segment on the overview page.
  • To see an example, click here.

Template

  • First Sentences:
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3]. Common complications of [disease name] include [complication 1], [complication 2], and [complication 3]. Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
OR
Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
  • Examples:
Example 1: If left untreated, 20% to 30% of patients with IgA nephropathy may progress to develop ESRD. Common complications of IgA nephropathy include pro-thrombotic states, such as stroke and myocardial infarction. Prognosis is generally good, and the 5-year mortality rate of patients with IgA nephropathy is approximately 5%.
  • Additional Sentences:
[Disease/malignancy] is associated with a 5 year survival rate of [#]%.
The presence of metastasis is associated with a particularly poor prognosis among patients with [disease/malignancy]. The 5 year event free survival rate is less than [#]%.
The [Subtype of disease or malignancy] is associated with the most favorable prognosis.
The prognosis varies with the [characteristic] of tumor: [subtype of disease/malignancy] have the most favorable prognosis.
  • Examples:
Example 1: Rhabdomyosarcoma is associated with a 5 year survival rate of 72%.
Example 2: The presence of metastasis is associated with a particularly poor prognosis among patients with rhabdomyosarcoma. The 5 year event free survival rate is less than 30%.
Example 3: The embryonal subtype of rhabdomyosarcoma is associated with the most favorable prognosis.
Example 4: The prognosis varies with the location of tumor: orbital and genitourinary tract rhabdomyosarcomas have the most favorable prognosis.

Preferred Template Statements

  • If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
  • Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.

 

Additional Sentences

  • The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
  • [Subtype of disease/malignancy] is associated with the most favorable prognosis.
  • The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.

Natural History

  • The natural history of disease details how the disease progresses without treatment.
  • Here are a few template sentences you can use: "The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___. The symptoms of (disease name) typically develop ___ years after exposure to ___. Without treatment, the patient will develop symptoms of ___, which will/ may eventually lead to ___.

Complications

  • Using lists can be helpful for describing this section.
  • You can use these template sentences;
    • "Complications that can develop as a result of (disease name) are ___ (describe in list form)".
    • "Complications that can develop as a result of the treatment of (disease name) are ___ (describe in list form).
    • Next to each complication, provide a brief one sentence description detailing the complication.
  • For an example of the complications section in a natural history, complications and prognosis page, click here.

Prognosis

  • This section should detail the prognosis of the disease, both treated and untreated.
  • Here are some template sentences; "The prognosis of (disease name) is poor/good with treatment. Without treatment, (disease name) will result in ___. (Disease name) is associated with a 1/5/10 year mortality of __ among patient with ______ (for example high grade lesions). The presence of ___ is associated with a particularly poor prognosis among patients with (disease name).
  • For an example of a prognosis section within a natural history, complications and prognosis page, click here.

References

  • References should be cited for the material that you have put on your page. Type in {{reflist|2}}.This will generate your references in small font, in two columns, with links to the original article and abstract.
  • For information on how to add references into your page, click here.



References

  1. Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G; et al. (2015). "Goodpasture's syndrome: a clinical update". Autoimmun Rev. 14 (3): 246–53. doi:10.1016/j.autrev.2014.11.006. PMID 25462583.
  2. Panjwani AH, Deoskar RB, Falleiro J, Rajan KE (2003). "Goodpasture's Syndrome". Med J Armed Forces India. 59 (1): 77–9. doi:10.1016/S0377-1237(03)80119-3. PMC 4925784. PMID 27407468.
  3. Shah MK, Hugghins SY (2002). "Characteristics and outcomes of patients with Goodpasture's syndrome". South Med J. 95 (12): 1411–8. PMID 12597309.
  4. Moroni G, Ponticelli C (2014). "Rapidly progressive crescentic glomerulonephritis: Early treatment is a must". Autoimmun Rev. 13 (7): 723–9. doi:10.1016/j.autrev.2014.02.007. PMID 24657897.
  5. Levy JB, Hammad T, Coulthart A, Dougan T, Pusey CD (2004). "Clinical features and outcome of patients with both ANCA and anti-GBM antibodies". Kidney Int. 66 (4): 1535–40. doi:10.1111/j.1523-1755.2004.00917.x. PMID 15458448.
  6. Fernandes R, Freitas S, Cunha P, Alves G, Cotter J (2016). "Goodpasture's syndrome with absence of circulating anti-glomerular basement membrane antibodies: a case report". J Med Case Rep. 10 ( ): 205. doi:10.1186/s13256-016-0984-6. PMC 4962374. PMID 27459964.

Template:WH Template:WS