A 26-Year-Old Previously Healthy Man Comes to the Office with a 3-Week

A 26-year-old previously healthy man comes to the office with a 3-week history of shortness of breath, cough, and hemoptysis preceded by an upper respiratory tract infection.  He has no fever, night sweats, or weight loss.  His blood pressure is 150/85 mm Hg and pulse is 86/min and regular.  Physical examination reveals bilateral inspiratory crackles and lower extremity edema.  His creatinine is 4.1 mg/dL.  Urinalysis shows proteinuria and hematuria with dysmorphic red blood cells.  Bilateral pulmonary infiltrates are seen on chest x-ray.  He is also found to have an increased carbon monoxide diffusing capacity (DLCO) on pulmonary function testing.  Antibodies directed against which of the following is most likely to be associated with this patient's condition?

A) Alpha 3 chain of type IV collagen
B) Beta-hemolytic streptococci
C) Cardiolipin phospholipid
D) Double-stranded DNA
E) Topoisomerase I

Correct Answer:

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