American Board of Internal Medicine (ABIM) Certification Practice Exam

Which autoantibody is associated with Goodpasture syndrome?

1. Anti-centromere

2. Anti-basement membrane

3. Anti-desmoglein

4. Anti-Jo-1

The correct answer is: Anti-basement membrane

Goodpasture syndrome is characterized by the presence of anti-basement membrane antibodies. This condition primarily affects the kidneys and lungs, leading to rapidly progressive glomerulonephritis and pulmonary hemorrhage. The autoantibodies specifically target a component of the glomerular and alveolar basement membrane, which is made up primarily of type IV collagen. The presence of these antibodies is pivotal for both diagnostics and understanding the pathophysiology of Goodpasture syndrome, as they cause an autoimmune reaction resulting in inflammation and damage to the basement membranes in these organs. Detecting anti-basement membrane antibodies through serological tests can help confirm the diagnosis. The other autoantibodies listed do not pertain to Goodpasture syndrome. Anti-centromere antibodies are often found in limited scleroderma, anti-desmoglein antibodies are associated with pemphigus vulgaris, and anti-Jo-1 antibodies are linked with polymyositis and dermatomyositis. Each of these autoimmune conditions has distinct autoimmune markers, differentiating them from Goodpasture syndrome.