Cigarette smoking and lung haemorrhage in glomerulonephritis caused by autoantibodies to glomerular basement membrane.

The smoking habits of 51 patients with glomerulonephritis caused by autoantibodies to the glomerular basement membrane (GBM) were investigated. 43 patients also had pulmonary haemorrhage; 8 did not. A full smoking history was obtained from 47 patients. Of these, all 37 cigarette smokers suffered lung haemorrhage, compared with only 2 of 10 non-smokers. There was no significant difference between the titres of circulating anti-GBM antibodies in smokers and non-smokers. In 1 patient resumption of smoking was closely followed by recrudescence of lung haemorrhage. These results largely explain the variable presence of pulmonary haemorrhage in anti-GBM disease.