Alveolar hemorrhage and hemosiderin laden macrophages -

Ans. is 'b' Goodpasture syndrome Goodpasture syndromeo Goodpasture syndrome is a rare condition characterized by rapid destruction of the kidney and diffuse pulmonary hemorrhage.o It is an autoimmune disease characterized by presence of circulating autoantibodies targeted against basement membrane oflung and kidney.o These antibodies are directed against the noncollagenous domain of the a-3 chain of type IV collegen (collegen of basement membrane).o The antibodies initiate an inflammatory destruction of the basement membrane in kidney glomeruli and lung alveoli.o In Goodpasture syndrome, immune reaction is ty pe II hypersensitivity.Morphological changesLungo The lungs are heavy, with areas of red brown consolidation.o There is focal necrosis of alveolar walls associated with intraalveolar hemorrhages.o Alveoli contain hemosiderin-laden macrophages.o Linear deposits of immunoglobulins along the basement membranes of the septal walls.Kidneyo Diffuse proliferative rapidly progressive glomerulonephritis,o Focal necrotizing lesion and crescents in >50% of glomeruli.o Linear deposits of immunoglobulins and complement along glomerular basement membrane.Clinical manifestationso Occur typically in young males.o Most cases begin clinically with respiratory' symptoms, principally hemoptysis.o Soon, manifestations of glomerulonephritis appear and typically present as nephritic syndrome - hematuria, nephritic urinary- sediment, subnephrotic proteinuria, rapidly progressive renal failure,o The common cause of death is renal failure.