Differential Diagnosis for Pulmonary Hemorrhage and Glomerulonephritis

• Single most likely diagnosis
  • Goodpasture Syndrome: This is the most likely diagnosis given the combination of pulmonary hemorrhage and glomerulonephritis. Goodpasture syndrome is an autoimmune disease characterized by the presence of anti-GBM antibodies, which target the basement membranes of the lungs and kidneys, leading to the symptoms presented.
• Other Likely diagnoses
  • Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): This is a form of vasculitis that affects small- and medium-sized vessels and can present with a combination of respiratory and renal symptoms, including pulmonary hemorrhage and glomerulonephritis.
  • Microscopic Polyangiitis (MPA): Another form of vasculitis that can cause pulmonary hemorrhage and glomerulonephritis due to inflammation of small blood vessels.
• Do Not Miss
  • Systemic Lupus Erythematosus (SLE): Although less common to present with this specific combination of symptoms, SLE can cause both pulmonary hemorrhage and glomerulonephritis and is critical not to miss due to its potential for severe morbidity and mortality.
  • Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated Vasculitis: This includes conditions like GPA and MPA but is listed separately to emphasize the importance of considering ANCA-associated vasculitis as a whole, given its potential severity and the need for prompt treatment.
• Rare diagnoses
  • IgA Vasculitis (Henoch-Schönlein Purpura): Typically presents with skin, joint, and gastrointestinal symptoms but can rarely cause pulmonary hemorrhage and glomerulonephritis.
  • Ehlers-Danlos Syndrome with Vasculature Involvement: A genetic disorder that can lead to vascular fragility and potentially to hemorrhagic complications, though it's a very rare cause of the specific symptoms mentioned.