Anti-GBM - Rx

Q: A 52-year-old male presented to the Emergency Department (ED) with hemoptysis and a creatinine level of 6.2 mg/dL. There is a high degree of suspicion for the Anti-glomerular basement membrane (anti-GBM) disease, also known as Goodpasture syndrome. What is the first line of treatment?

A) Immunosuppressive therapy

B) Plasmapheresis

C) Plasmapheresis plus immunosuppressive therapy

Answer: C

The initial management of anti-GBM disease plays an essential role in immediate and long-term survival. The treatment is two-pronged:

• Plasmapheresis removes circulating anti-GBM antibodies and other inflammatory mediators, and 
• Immunosuppressive agents minimize new antibody formation

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#nephrology

References:

1. McAdoo SP, Pusey CD. Anti-glomerular basement membrane disease-treatment standard. Nephrol Dial Transplant. 2025 Dec 23;41(1):42-54. doi: 10.1093/ndt/gfaf190. PMID: 40973182; PMCID: PMC12722177.

2. Bharati J, Jhaveri KD, Salama AD, Oni L. Anti-Glomerular Basement Membrane Disease: Recent Updates. Adv Kidney Dis Health. 2024 May;31(3):206-215. doi: 10.1053/j.akdh.2024.04.007. PMID: 39004460.

3. Taylor DM, Yehia M, Simpson IJ, et al. Anti-glomerular basement membrane disease in Auckland. Intern Med J 2012; 42:672.

4. Canney M, O'Hara PV, McEvoy CM, et al. Spatial and Temporal Clustering of Anti-Glomerular Basement Membrane Disease. Clin J Am Soc Nephrol 2016; 11:1392.