Anti-GBM pulmonary-renal syndrome: when the laboratory makes the difference

Objectives: Pulmonary-renal syndrome (PRS) is a serious condition characterized by concurrent alveolar hemorrhage and rapidly progressive glomerulonephritis. One of the potential causes of PRS is the presence of anti-glomerular basement membrane (anti-GBM) antibodies, which may induce Goodpasture syndrome, a rare, albeit life-threatening, condition associated with a high mortality. Case presentation: We report the case of a 31 year-old male patient with Huntington's disease who presented with dyspnea, a dry cough, and asthenia. Urgent laboratory tests demonstrated severe anemia, acute kidney failure, and additional laboratory abnormalities consistent with vasculitis. Chest CT scan revealed diffuse alveolar hemorrhage. The autoimmune panel was anti-GBM positive, thereby leading to diagnosis of Goodpasture syndrome. Conclusions: Goodpasture syndrome is a form of pulmonary-renal syndrome that requires prompt diagnosis and intensive immunosuppressive therapy. Patients may follow a severe course and progress into end-stage renal disease. Early detection of anti-GBM antibodies is essential for diagnosis. The clinical laboratory plays a major role in supporting therapeutic decision-making and treatment response monitoring.