Wegener's vs. Goodpastures

[poloace]

scenario-

33 year old woman presents with history of purulent discharge from the left nostril for the past few months. has also had mild nonproductive cough and occasional shortness of breath. underwent treatment for sinusitis 3x in last few months with no improvement of symptoms. also complains of easy fatigability and loss of weight. CXR shows nodules and pulmonary infiltrates. lab values are WBC 15000, and Hb 10. Ua is 3+ protein, 7-10 RBCs/HPF and red blood cell casts. which of the following should be added to the workup to confirm the diagnosis?

a- measurement of anti basement membrane antibody
b- measurement of serum anti neutrophil cytoplasmic antibody.


????- the answer is b.

so- how do you differentiate the two?? i keep getting these wrong. sometimes both have hemoptysis... so, that doesn't help. anyone??

p

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[footcramp]

sinusitis = wegeners

 

[moviefreak]

wegener'sinvolves both upper and lower resp tract vs. goodpasture's just lower resp tract.

 

[FarEastGrapplr2]

answer = B

the way i remember "W"egener's is... the "W" has 3 peaks. 3 manifestations = upper resp, lower resp, and renal

"G"oodpasture's look for anti-"G"BM (you must however Not see Upper Resp involvement)

 

[Idiopathic]

Pretty much the long and short of it. Goodpasture's can confuse this because of the LOWER resp symptoms, but Wegeners is the one that gives UPPER in addition to LOWER respiratory symptoms. Aside from that, these two vasculitides mimic each other very closely, so you need the sinus symptoms to make the clinical diagnosis.

 

[Diana_UC]

answer = B

the way i remember "W"egener's is... the "W" has 3 peaks. 3 manifestations = upper resp, lower resp, and renal

"G"oodpasture's look for anti-"G"BM (you must however Not see Upper Resp involvement)

That's REALLY good ... I like it!