Question 155

Question:

A 42-year-old male presents to you with recent episodes of bloody urine and blood streaked sputum. A biopsy of his kidney is taken and immunofluorescence demonstrates linear deposits on the basement membrane. The reaction which led to the patient’s condition is most similar to which of the following reactions?

Correct Answer: E.  Graves’ disease

Hemoptysis and hematuria are two of the presenting symptoms of Goodpasture’s syndrome, which is this patient’s diagnosis. This condition develops via a type II hypersensitivity reaction with antibodies to the glomerular basement membrane. The finding of linear deposits on immunoflourescence helps to confirm the diagnosis. Of the choices listed, only Graves’ disease is a type II hypersensitivity reaction. Contact dermatitis due to poison ivy and a positive PPD test are examples of type IV delayed hypersensitivity. Henoch–Schönlein purpura is an immune complex type III hypersensitivity with IgA deposits in blood vessels. The reaction to a bee sting would be an example of an anaphylactic reaction, which is a type I hypersensitivity.