Goodpasture syndrome medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Currently there is no cure for Goodpasture syndrome.The mainstay of therapy for Goodpasture syndrome consist of corticosteriods, cyclophosphamide and plasmapheresis. | Currently there is no cure for Goodpasture syndrome.The mainstay of therapy for Goodpasture syndrome consist of corticosteriods, cyclophosphamide and plasmapheresis. | ||
==Medical Therapy== | ==Medical Therapy== | ||
Goodpasture’s syndrome | * The mainstay of treatment for Goodpasture’s syndrome includes medical therapy with [[corticosteroid]]s [[immunosuppressant]]s, and [[plasmapheresis]].<ref name="pmid25462583">{{cite journal| author=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G et al.| title=Goodpasture's syndrome: a clinical update. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 3 | pages= 246-53 | pmid=25462583 | doi=10.1016/j.autrev.2014.11.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25462583 }}</ref> | ||
* Treatment of Goodpasture syndrome should begin before serum creatinine levels are greater than 5.7mg/dl, before the development of anuria, and the need for renal dialysis. | |||
* The normal duration of medical therapy in patients with Goodpasture syndrome includes:<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> | |||
** [[Corticosteriod]]s are given for at least 6 months in tapering doses with [[immunosuppressant]]s for 2 to 3 months. | |||
** [[Plasmapheresis]] is given for 10 to 14 treatments. | |||
* 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 22:25, 28 April 2018
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Goodpasture syndrome Microchapters |
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Goodpasture syndrome medical therapy On the Web |
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Risk calculators and risk factors for Goodpasture syndrome medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]
Overview
Currently there is no cure for Goodpasture syndrome.The mainstay of therapy for Goodpasture syndrome consist of corticosteriods, cyclophosphamide and plasmapheresis.
Medical Therapy
- The mainstay of treatment for Goodpasture’s syndrome includes medical therapy with corticosteroids immunosuppressants, and plasmapheresis.[1]
- Treatment of Goodpasture syndrome should begin before serum creatinine levels are greater than 5.7mg/dl, before the development of anuria, and the need for renal dialysis.
- The normal duration of medical therapy in patients with Goodpasture syndrome includes:[2]
- Corticosteriods are given for at least 6 months in tapering doses with immunosuppressants for 2 to 3 months.
- Plasmapheresis is given for 10 to 14 treatments.
- 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.[3]
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.[4]
References
- ↑ Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G; et al. (2015). "Goodpasture's syndrome: a clinical update". Autoimmun Rev. 14 (3): 246–53. doi:10.1016/j.autrev.2014.11.006. PMID 25462583.
- ↑ "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.