علاج الخط الأول لمتلازمة غودباستشر

References

DOI: 10.1038/kisup.2012.27

• We recommend initiating immunosuppression with cyclophosphamide and glucocorticoids plus plasmapheresis in all patients with anti-GBM GN except those who are treated with dialysis at presentation, have 100% crescents or >50% global glomerulosclerosis in an adequate biopsy sample, and do not have pulmonary hemorrhage.
• Plasma exchange should be performed until anti-GBM titers are no longer detectable.
• As the risk of infection in patients with kidney failure treated with cyclophosphamide is high, prophylaxis of Pneumocystis pneumonia with cotrimoxazole can be considered.
• Antibodies are cleared in most patients treated with plasma exchange combined with immunosuppression within 8 weeks.
• Treatment usually results in recovery from alveolar hemorrhage.