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Plasmapheresis and immunosuppressive agents in antibasement membrane antibody-induced Goodpasture's syndrome

1978; Elsevier BV; Volume: 64; Issue: 2 Linguagem: Inglês

10.1016/0002-9343(78)90065-7

1555-7162

John P. Johnson, Walter Whitman, William A. Briggs, Curtis B. Wilson,

Coagulation, Bradykinin, Polyphosphates, and Angioedema

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.