Correspondence (letter to the editor): Particularities of Goodpasture Syndrome

The article outlines the invasive therapeutic options for the treatment of hemoptysis (1). However, in my view, the peculiarities of hemoptysis treatment in Goodpasture syndrome should be at least briefly discussed (2). Although this syndrome is rare, hemoptysis is often the main acute threat to the patient‘s life and is an urgent indication for removal of the pathogenic anti-basement membrane antibodies by plasmapheresis. As the target antigen of the antibody (the non-collagenous domain of the alpha 3 chain of type IV collagen) is accessible both in alveolar as well as in glomerular basement membranes, and as hemoptysis can be induced in animals using anti-basement membrane antibodies (3), there should be little doubt about the pathogenetic role of the antibodies. This importance of these antibodies seems to be also demonstrated by the observation that hemoptysis sometimes stops during plasmapheresis, although of course drugs such as cyclophosphamide, prednisolone, and perhaps rituximab are indispensable for the permanent control of the clinical picture (2, 4).