Differential Diagnosis for Goodpasture Syndrome with Haemoptysis and Crescentic Lesions
- Single most likely diagnosis:
- Rapidly progressive GN (RPGN): This is the most likely diagnosis given the patient's symptoms of haemoptysis, which is a common presentation of Goodpasture syndrome, and the biopsy findings of crescent-shaped inflammatory lesions. RPGN is characterized by a rapid decline in renal function and is often associated with crescentic glomerulonephritis, which is consistent with the biopsy results.
- Other Likely diagnoses:
- Acute GN: While less likely than RPGN, acute glomerulonephritis (GN) could also present with haemoptysis and renal inflammation. However, the presence of crescentic lesions and the rapid progression of symptoms make RPGN a more likely diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary-renal syndromes (e.g., ANCA-associated vasculitis): Although Goodpasture syndrome is already diagnosed, other pulmonary-renal syndromes could present similarly and have a high mortality rate if not promptly treated. It's essential to consider these diagnoses to ensure appropriate management.
- Rare diagnoses:
- Nephrotic syndrome: This diagnosis is less likely given the patient's symptoms of haemoptysis and the biopsy findings of crescentic lesions, which are more characteristic of nephritic syndromes like RPGN.
- Minimal change disease: This condition typically presents with nephrotic syndrome and is characterized by minimal glomerular changes on light microscopy, making it an unlikely diagnosis in this case.