In anti-GBM disease, standard first-line management typically incorporates cyclophosphamide. When patients are intolerant of cyclophosphamide or decline it, a structured alternative approach is needed. Case reports document successful outcomes in this specific patient group.
Anti-GBM disease with intolerance of, or refusal of, cyclophosphamide — for example due to its toxicity or patient preference. An alternative immunosuppressive agent can be substituted within an otherwise similar treatment framework.
Mycophenolate could be used instead of cyclophosphamide in patients who refuse cyclophosphamide or are intolerant of cyclophosphamide because of its toxicity.
There are several case reports of patients with anti-GBM disease who were successfully treated with mycophenolate or MPA instead of cyclophosphamide.
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