Plasmapheresis and immunosuppressive agents in antibasement membrane antibody-induced Goodpasture's syndrome.
Four patients with rapidly progressive glomerulonephritis and pulmonary hemorrhage (Goodpasture's syndrome) induced by circulating anti-glomerular basement membrane (GBM) antibodies were treated with immunosuppressive agents and varying amounts of plasma exchange. All four patients showed progressive decreases in circulating anti-GBM antibody during therapy. Two patients with established renal failure before therapy showed no improvement in renal function but had a remission from pulmonary disease. In two other patients, renal failure developed early in the course of therapy and required maintenance hemodialysis. Later, their renal function improved coincident with a decrease in circulating anti-GBM antibody. Aggressive measures to reduce the levels of circulating anti-GBM antibody may have a salutory effect on the clinical course of the disease, particularly when undertaken early.
D000293:Adolescent; D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications / Q000276:immunology* / Q000601:surgery / Q000628:therapy; D000906:Antibodies; D001485:Basement Membrane / Q000276:immunology; D006470:Hemorrhage / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000276:immunology*; D008171:Lung Diseases / Q000276:immunology; D008297:Male; D009392:Nephrectomy; D010956:Plasmapheresis
D000906:Antibodies; D007166:Immunosuppressive Agents