Goodpastures Syndrome

Too close for comfort - a near-fatal encounter, told by the patient

17. Goodpasture's Syndrome - Thoughts on Causes

(This is a true account of my experience with Goodpastures Syndrome, but a few people’s names have been changed, indicated by *.  My aim in writing this is threefold; first, that victims and families of people suffering from Goodpastures Syndrome can have some knowledge of what to expect in a serious event but also to show that Goodpastures is survivable, even in a case like mine; second, it would do no harm for physicians treating Goodpastures Syndrome or other devastating diseases, not to mention GP’s prescribing medication to patients, to read this as there are lessons here for some of them; lastly I am trying to exorcise the psychological after-effects of my experience with Goodpastures Syndrome).

I have not tried to keep up to date with research on Goodpasture’s Syndrome and therefore, so far as I know, it remains classified as an idiopathic disease or, in other words, of unknown origin.  I am sure, however, that the body of knowledge has increased vastly in the intervening years and perhaps at some stage I must see what I can find on the internet.

One theory, which seems to be the major theory, concerns the ingestion or inhalation of hydrocarbons whereby, at the risk of medical over-simplification, once the hydrocarbon molecules get into the lungs they can transfer to the bloodstream, triggering an immune reaction.  It would seem that there are cases where there has been a demonstrable connection with hydrocarbons so this theory looks good for at least some cases.

Dr. Crafford my psychiatrist, however, told me of another theory related to depression.  Research has apparently shown that one of the areas of the brain adversely affected by depression is the part that controls the immune system.  The theory is that if depression places too great a strain on the brain then an auto-immune reaction could be triggered.  It is of course tempting to believe that each branch of medicine can look at a problem from its own point of view and come up with a theory relevant to itself.

Nevertheless, although just a theory, it is interesting in my case for two reasons; firstly, I have suffered from an major depressive disorder since childhood and, secondly, in the several years prior to my departure from Pietermaritzburg this depression was greatly intensified by the despair I was feeling. Without being able to say that this was actually the cause, it is at the very least a remarkable co-incidence of possible cause and effect, making it just possible that I was already ill prior to arriving in Port Elizabeth.  In fact, a former colleague from Pietermaritzburg has remarked that to him I “looked” ill before I left.

This is not advanced as being THE cause but as A possible alternative cause to the hydrocarbon theory and, also, in my case I can not recall contact with hydrocarbons which might have triggered the Goodpastures.

It would be interesting to know if there have been any other instances of Goodpasture's Syndrome where the patient was depressive but I doubt if data would be available.  Nobody asked me during the time I was in hospital if I suffered from depression which is not surprising considering the gross physical symptoms which I was exhibiting.

All this discussion of theories presumes, of course, that it is possible for a medical condition to have a variety of causes, another matter on which I am not qualified to comment.



Goodpasture's Syndrome - Thoughts on Causes             copyright 2011 Richard Binstead Goodpasture's Syndrome

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