CTICasesGoodpasture Syndrome Triggered by Marijuana Inhalation
Imaging findings
Frontal chest radiograph and CT scan from a young male marijuana smoker show a diffuse, basilar-predominant centrilobular nodular and bronchiolar pattern. Lung biopsy demonstrated acute fibrinous and organizing pneumonia, with plugs of organizing pneumonia within the distal airways. The patient later presented with biopsy-confirmed Goodpasture syndrome with renal and pulmonary basement membrane involvement.
Key takeaways
Inhalation of toxins, such as marijuana smoke or butane-extracted concentrates, can induce severe, basilar-predominant bronchiolitis and acute fibrinous and organizing pneumonia. The resulting alveolar epithelial and basement membrane damage is a known trigger that can expose collagen antigens, prompting the development of anti-GBM antibodies and subsequent Goodpasture syndrome.
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