A 29-year-old man who has had no major illnesses experiences acute onset of hemoptysis. On physical examination, he has a temperature of 37deg C, pulse of 83/min, respirations of 28/min, and blood pressure of 150/95 mm Hg. A chest radiograph shows bilateral fluffy infiltrates. A transbronchial lung biopsy on microscopic examination shows focal necrosis of alveolar walls associated with prominent intra-alveolar hemorrhage. Two days later, he has oliguria. The serum creatinine level is 2.9 mg/dL, and urea nitrogen is 31 mg/dL. Which of the following antibodies is most likely involved in the pathogenesis of his condition?
Goodpasture syndrome leads to renal and pulmonary lesions produced by an antibody directed against an antigen common to the basement membrane in glomerulus and alveolus. This leads to a type II hypersensitivity reaction. The anti-DNA topoisomerase I antibody is a marker for scleroderma. Antimitochondrial antibody is associated with primary biliary cirrhosis. C-ANCA and P-ANCA are best known as markers for various forms of systemic vasculitis. ANA is used as a general screening test for various autoimmune conditions, typically collagen vascular diseases such as systemic lupus erythematosus.
Anti-DNA topoisomerase I antibody
Anti-glomerular basement membrane antibody
Antimitochondrial antibody
Anti-neutrophil cytoplasmic antibody
Respiration