Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage

Figure 1

(a) Light microscopy reveals glomeruli with cellular to focally fibrocellular crescent formation and underlying segmental tuft fibrinoid necrosis. Red blood cell casts are noted. There is severe mononuclear inflammation within the interstitium (H&E, 10x). (b) Electron microscopy demonstrates peripheral capillary loops of normal thickness and architecture with widespread effacement of the overlying foot processes. (c) Immunofluorescence microscopy shows strong linear staining along glomerular basement membranes with IgG (4+) and kappa and lambda light chains (3-4+).

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