The Figure Shows Routine Histologic and Immunofluorescence Images of a Kidney

Multiple Choice

The figure shows routine histologic and immunofluorescence images of a kidney biopsy specimen taken from a 53-year-old man with acute-onset renal failure and hemoptysis (coughing up blood) . The histologic section is notable for glomerular inflammation in a crescentic distribution. Staining, using fluorescently tagged anti-IgG antibody, shows linear deposits of IgG along the glomerular basement membrane. Urinalysis is positive for moderate proteinuria and red cell casts. A chest radiograph shows pulmonary infiltrates. Which of the following is the most likely diagnosis?

A) Systemic lupus erythematosus
B) Graves' disease
C) Chronic allograft rejection
D) Goodpasture's syndrome
E) Poststreptococcal glomerulonephritis