Goodpasture Syndrome

Goodpasture syndrome is the pulmonary–renal presentation of anti-glomerular basement membrane disease. Pathogenic antibodies injure glomerular capillaries and may also injure alveolar capillaries, so rapidly progressive glomerulonephritis and diffuse alveolar hemorrhage can occur together. The high-risk pattern is hemoptysis or otherwise unexplained respiratory deterioration with glomerular hematuria and worsening kidney function. Treat this combination as an emergency, not as two unrelated problems. The RN’s first priorities are airway, breathing, circulation, oxygenation, hemodynamic stability, and urine output while activating the emergency response appropriate to the patient’s condition. Obtain ordered specimens promptly, prepare for urgent imaging and kidney biopsy, and coordinate nephrology, critical-care, respiratory, and apheresis support. The RN does not independently diagnose anti-GBM disease or prescribe immunosuppression; the nursing role is rapid recognition, stabilization under protocol or order, safe treatment delivery, surveillance for complications, and clear escalation.