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Anti-glomerular basement membrane (GBM) nephritis is a rapidly progressive glomerulonephritis (RPGN) due to autoantibodies directed against the noncollagenous 1 domain of type IV collagen in the GBM. The eponym ‘Goodpasture's syndrome’ is used in cases of renal and pulmonary involvement, typically in the form of pulmonary hemorrhage. The disease can be diagnosed clinically in a patient with a RPGN––defined as at least 50% decline in renal function in <3 months with evidence of glomerular injury via hematuria and proteinuria [1]––if circulating anti-GBM antibodies are detectable by an enzyme-linked immunosorbent assay (ELISA). However, a firm diagnosis can only be made by a renal biopsy demonstrating a crescentic glomerulonephritis on light microscopy and diffuse, linear localization of IgG along the GBM on immunofluorescence (IF).

Anti-glomerular basement membrane nephritis: why we still 'need' the kidney biopsy