Anti-α 1(IV) Collagen Autoantibodies Associated with Lung Adenocarcinoma Presenting as the Goodpasture Syndrome
Authors: Raghu Kalluri, Savas Petrides, Curtis B. Wilson, John E. Tomaszewski, Harold I. Palevsky, Michael A. Grippi, Michael P. Madaio, Eric G. Neilson
Journal: Annals of Internal Medicine (1996)

Brief Communications1 April 1996Anti-α 1(IV) Collagen Autoantibodies Associated with Lung Adenocarcinoma Presenting as the Goodpasture SyndromeRaghu Kalluri, PhD, Savas Petrides, MD, Curtis B. Wilson, MD, John E. Tomaszewski, MD, Harold I. Palevsky, MD, Michael A. Grippi, MD, Michael P. Madaio, MD, and Eric G. Neilson, MDRaghu Kalluri, PhDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, Savas Petrides, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, Curtis B. Wilson, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, John E. Tomaszewski, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, Harold I. Palevsky, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, Michael A. Grippi, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, Michael P. Madaio, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this author, and Eric G. Neilson, MDFrom the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-7-199604010-00005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail We report a case of adenocarcinoma of the lung with hemoptysis that was mistaken for the Goodpasture syndrome on the basis of a serologic test for antiglomerular basement membrane antibodies. Antiglomerular basement membrane antibodies are characteristic of the Goodpasture syndrome, some forms of rapidly progressive glomerulonephritis, and isolated instances of pulmonary hemorrhage. Antiglomerular basement membrane antibodies from patients with traditional Goodpasture syndrome react with the α 3(IV) chain, one of the six known chains of type IV collagen that form an integrative lattice called basement membrane [1, 2]. Evaluation of the antiglomerular basement membrane antibodies in our patient showed the ...References1. Meyers CM, Kalluri R, Neilson EG. Anti-basement membrane antibodies in Goodpasture syndrome. In: Neilson EG, Couser WC, eds. Immunologic Renal Diseases. New York: Lippincott-Raven; [In press]. Google Scholar2. Kalluri R, Weber M, Wilson CB, Neilson EG, Hudson B. Identification of the α 3(IV) chain of type IV collagen as the common autoantigen in antibasement membrane disease and Goodpasture syndrome. J Am Soc Nephrol. 1994; 6:1199-04. Google Scholar3. Neilson EG, Kalluri R, Sun MJ, Gunwar S, Danoff T, Mariyama M, et al. Specificity of Goodpasture autoantibodies for the recombinant noncollagenous domains of human type IV collagen. J Biol Chem. 1993; 268:8402-5. Google Scholar4. Kalluri R, Gattone VH Jr, Noelken ME, Hudson BG. The α 3 chain of type IV collagen induces autoimmune Goodpasture Syndrome. Proc Natl Acad Sci U S A. 1994; 91:6201-5. Google Scholar5. Wilson CB. Radioimmunoassay for anti-glomerular basement membrane antibodies. In: Friedman H, Rose NR, eds. Manual of Clinical Immunology. Washington, DC: American Society for Microbiology; 1980:376. Google Scholar6. Wilson CB. The renal response to immunological injury. In: Brenner BM, Rector FC, eds. The Kidney. 4th ed. v. 1. Philadelphia: WB Saunders; 1991:1062-181. Google Scholar7. Bailey RR, Simpson IJ, Lynn KL, Neale TJ, Doak PB, Mcgiven AR. Goodpasture's syndrome with normal renal function. Clin Nephrol. 1981; 15:211-5. Google Scholar8. Aznavoorian S, Murphy AN, Stetler-Stevenson WG, Liotta LA. Molecular aspects of tumor cell invasion and metastasis. Cancer. 1993; 71:1368-83. Google Scholar9. Isobe H, Iwata S, Fujime M, Kitagawa R. [Serum concentration of type IV collagen in urological cancer—comparison with serum concentration of laminin]. Nippon Hinyokika Gakkai Zasshi. 1993; 84:457-62. Google Scholar10. Yudoh K, Matsui H, Kanamori M, Ohmori K, Tsuji H, Tatezaki S. Serum levels of laminin, type IV collagen and type III procollagen peptide as markers for detection of metastasis. Jpn J Cancer Res. 1994; 85:1263-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Raghu Kalluri, PhD; Savas Petrides, MD; Curtis B. Wilson, MD; John E. Tomaszewski, MD; Harold I. Palevsky, MD; Michael A. Grippi, MD; Michael P. Madaio, MD; Eric G. Neilson, MDAffiliations: From the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and The Scripps Research Institute, La Jolla, California.Acknowledgments: The authors thank Marilyn Salcheider for technical assistance; Michael Rosen, MD, for referring the patient to the Hospital of University of Pennsylvania; and Dr. Billy G. Hudson for providing the Goodpasture antibodies.Grant Support: In part by National Institutes of Health grants DK-07006, DK-30280, DK-45191, and DK-20043 and the DCI RED fund.Corresponding Author: Eric G. Neilson, MD, 700 Clinical Research Building, Penn Center for Molecular Studies of Kidney Diseases, Renal Electrolyte and Hypertension Division, University of Pennsylvania, 422 Curie Boulevard, Philadelphia, PA 19104-6144.Current Author Addresses: Drs. Kalluri, Petrides, Madaio, and Neilson: 700 Clinical Research Building, Renal Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, 422 Curie Boulevard, Philadelphia, PA 19104-6144. Dr. Wilson: Department of Immunology, The Scripps Research Institute, 10666 North Torrey Pines Road, La Jolla, CA 92037. Dr. Tomaszewski: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAutoimmunity in Anti–Glomerular Basement Membrane Disease: A Review of Mechanisms and Prospects for ImmunotherapyThe Clinical and Immunologic Features of Patients With Combined Anti-GBM Disease and Castleman DiseaseCas clinique n° 3 : Une hémorragie intra-alvéolaire atypiqueHemophagocytic Lymphohistiocytosis in a Patient with Goodpasture’s Syndrome: A Rare Clinical AssociationLocal radiotherapy increases the level of autoantibodies to ribosomal P0 protein but not to heat shock proteins, extracellular matrix molecules and EGFR/ErbB2 receptors in prostate cancer patientsCrescentic Glomerulonephritis with Anti-GBM and p-ANCA AntibodiesAdvances in human antiglomerular basement membrane diseaseAnti-glomerular Basement Disease: Goodpasture’s SyndromeAnti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severityMammalian collagen IVImmunological Mechanisms of Interstitial DiseaseA 59-kd Renal Antigen as a New Target for Rapidly Progressive GlomerulonephritisAn unusual case of pulmonary-renal syndrome associated with defects in type IV collagen composition and anti-glomerular basement membrane autoantibodiesRecurrent Goodpasture’s disease secondary to a monoclonal IgA1-κ antibody autoreactive with the α1/α2 chains of type IV collagenPathogenesis of Goodpasture syndrome: a molecular perspectiveANCA and anti-GBM antibodies in diagnosis and follow-up of vasculitic diseaseAlport's Syndrome, Goodpasture's Syndrome, and Type IV CollagenHigh affinity of anti-GBM antibodies from Goodpasture and transplanted Alport patients to α3(IV)NC1 collagenReactive Oxygen Species Expose Cryptic Epitopes Associated with Autoimmune Goodpasture SyndromeIdentification of a clinically relevant immunodominant region of collagen IV in Goodpasture diseaseIdentification and Localization of Type IV Collagen Chains in the Inner Ear CochleaVery Early Onset of Acute Amiodarone Pulmonary Toxicity Presenting With Hemoptysis 1 April 1996Volume 124, Issue 7Page: 651-653KeywordsAdenocarcinomaAntibodiesAntigensBasement membraneEnzyme linked immunosorbent assayHemorrhageLungsRadioimmunoassaysResearch laboratoriesThorax ePublished: 15 August 2000 Issue Published: 1 April 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. 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