Renal Biopsy in Goodpasture's Disease

Goodpasture's disease is a rare autoimmune disorder characterized by the destruction of connective tissue in the air sacs (alveoli) of the lungs and the filtering components (glomeruli) of the kidneys. It is also known as Goodpasture's syndrome. If left untreated, this syndrome may cause lung disease and rapid, progressive kidney failure. Renal biopsy is a method commonly used to detect Goodpasture's disease in the kidneys.

Basics

• Goodpasture's disease in the kidneys occurs when immune system components called anti-glomerular basement membrane antibodies attack areas of the kidneys responsible for filtering waste and excess fluid from the blood. In some individuals, this attack is triggered by viral infection of the respiratory system or exposure to chemicals containing hydrocarbon solvents.

Renal Biopsy

• Renal biopsy---also called kidney biopsy---is a technique used to extract a small amount of kidney tissue to diagnose Goodpasture's disease, as well as other disorders. It is usually done in a hospital setting, and involves inserting a spring-loaded collection needle through the skin and into a kidney to gather a sample. Typically, doctors begin the procedure by lightly sedating the patient. They then determine the exact position of the kidney with X-rays or ultrasound images, along with a specialized locating needle. Before inserting the collection needle, they will apply a local anesthetic at the biopsy site.

  The collection needle is hollow, and once a sample is taken it is held in the needle's interior. To collect a sufficient amount of sample material, doctors may need to insert the biopsy needle as many as three of four times. Each individual insertion takes roughly 30 seconds.

Significance

• In some individuals, Goodpasture's disease develops slowly, and may not cause serious effects for a number of months or years. However, in other individuals, damage may occur in just a few weeks, or even days. Since doctors cannot know beforehand how quickly the disease will progress in a given individual, rapid diagnosis is critical to avoid serious, permanent kidney damage. Although other effective methods of diagnosing Goodpasture's exist, for some individuals the direct tissue examination made possible by biopsy may be essential.

After a Biopsy

• After a renal biopsy, doctors will test the acquired tissue samples for signs of anti-glomerular antibodies. It may take several days to get the full result of this examination. If anti-glomerular antibodies are discovered, treatment for Goodpasture's disease will begin. Potential treatment options include oral immunosuppressive medications such as corticosteroids and cyclophosphamide, and a procedure called plasmapheresis, in which the harmful antibodies are mechanically removed from the bloodstream.

Considerations

• Potential side effects of renal biopsy include bleeding, bloody urine, fever, dizziness, increasing pain at the site of the biopsy and inability to urinate. In some rare cases, infection may also occur. Individuals who experience these side effects should report them to their healthcare providers as soon as possible.