Goodpasture syndrome medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
Goodpasture’s syndrome responds well to treatment with [[corticosteroid]]s [[immunosuppressant]]s, and [[plasmapheresis]]. Treatment of Goodpasture's should begin before serum creatinine levels are greater than 5.7mg/dl, before the development of anuria, and the need for renal dialysis. [[Corticosteriod]]s are given for at least 6 months in tapering doses, [[immunosuppressant]]s are given for 2 to 3 months, and [[plasmapheresis]] is given for 10 to 14 treatments.<ref name="pmid25018939">{{cite journal| author=| title=Chapter 14: Anti-glomerular basement membrane antibody glomerulonephritis. | journal=Kidney Int Suppl (2011) | year= 2012 | volume= 2 | issue= 2 | pages= 240-242 | pmid=25018939 | doi=10.1038/kisup.2012.27 | pmc=4089639 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25018939 }} </ref> | Goodpasture’s syndrome responds well to treatment with [[corticosteroid]]s [[immunosuppressant]]s, and [[plasmapheresis]]. Treatment of Goodpasture's should begin before serum creatinine levels are greater than 5.7mg/dl, before the development of anuria, and the need for renal dialysis. [[Corticosteriod]]s are given for at least 6 months in tapering doses, [[immunosuppressant]]s are given for 2 to 3 months, and [[plasmapheresis]] is given for 10 to 14 treatments.<ref name="pmid25018939">{{cite journal| author=| title=Chapter 14: Anti-glomerular basement membrane antibody glomerulonephritis. | journal=Kidney Int Suppl (2011) | year= 2012 | volume= 2 | issue= 2 | pages= 240-242 | pmid=25018939 | doi=10.1038/kisup.2012.27 | pmc=4089639 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25018939 }} </ref> | ||
Patients with advanced progression of Goodpasture syndrome however, are not always compliant to treatments of plasmapheresis, corticosteroids, and immunosuppressants. However, plasmapheresis may still be of benefit in patients who present with pulmonary hemorrhage.<ref name="pmid12815141">{{cite journal| author=Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG| title=Alport's syndrome, Goodpasture's syndrome, and type IV collagen. | journal=N Engl J Med | year= 2003 | volume= 348 | issue= 25 | pages= 2543-56 | pmid=12815141 | doi=10.1056/NEJMra022296 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12815141 }}</ref> | |||
An alternative treatment used for Goodpasture's is [[rituximab]]. The use of [[rituximab]] for 2 to 4 weeks is beneficial in the recovery of renal function in patients undergoing renal dialysis. However, its use as an induction therapy for Goodpasture's is not ideal because of its slow activation time.<ref name="pmid27049372">{{cite journal| author=Couser WG| title=Pathogenesis and treatment of glomerulonephritis-an update. | journal=J Bras Nefrol | year= 2016 | volume= 38 | issue= 1 | pages= 107-22 | pmid=27049372 | doi=10.5935/0101-2800.20160016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27049372 }} </ref> | An alternative treatment used for Goodpasture's is [[rituximab]]. The use of [[rituximab]] for 2 to 4 weeks is beneficial in the recovery of renal function in patients undergoing renal dialysis. However, its use as an induction therapy for Goodpasture's is not ideal because of its slow activation time.<ref name="pmid27049372">{{cite journal| author=Couser WG| title=Pathogenesis and treatment of glomerulonephritis-an update. | journal=J Bras Nefrol | year= 2016 | volume= 38 | issue= 1 | pages= 107-22 | pmid=27049372 | doi=10.5935/0101-2800.20160016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27049372 }} </ref> | ||
Revision as of 19:15, 4 November 2016
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Goodpasture syndrome Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The mainstay of therapy for Goodpasture syndrome is corticosteriods, cyclophosphamide and plasmapheresis.
Medical Therapy
Goodpasture’s syndrome responds well to treatment with corticosteroids immunosuppressants, and plasmapheresis. Treatment of Goodpasture's should begin before serum creatinine levels are greater than 5.7mg/dl, before the development of anuria, and the need for renal dialysis. Corticosteriods are given for at least 6 months in tapering doses, immunosuppressants are given for 2 to 3 months, and plasmapheresis is given for 10 to 14 treatments.[1]
Patients with advanced progression of Goodpasture syndrome however, are not always compliant to treatments of plasmapheresis, corticosteroids, and immunosuppressants. However, plasmapheresis may still be of benefit in patients who present with pulmonary hemorrhage.[2]
An alternative treatment used for Goodpasture's is rituximab. The use of rituximab for 2 to 4 weeks is beneficial in the recovery of renal function in patients undergoing renal dialysis. However, its use as an induction therapy for Goodpasture's is not ideal because of its slow activation time.[3]
References
- ↑ "Chapter 14: Anti-glomerular basement membrane antibody glomerulonephritis". Kidney Int Suppl (2011). 2 (2): 240–242. 2012. doi:10.1038/kisup.2012.27. PMC 4089639. PMID 25018939.
- ↑ Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG (2003). "Alport's syndrome, Goodpasture's syndrome, and type IV collagen". N Engl J Med. 348 (25): 2543–56. doi:10.1056/NEJMra022296. PMID 12815141.
- ↑ Couser WG (2016). "Pathogenesis and treatment of glomerulonephritis-an update". J Bras Nefrol. 38 (1): 107–22. doi:10.5935/0101-2800.20160016. PMID 27049372.