Goodpasture syndrome medical therapy: Difference between revisions
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** [[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> | ** [[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]].<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]].<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> | ||
** The use of [[rituximab]] for 2 to 4 weeks is beneficial in the recovery of renal function in patients undergoing renal dialysis. | *** The use of [[rituximab]] for 2 to 4 weeks is beneficial in the recovery of renal function in patients undergoing renal dialysis. | ||
** The use of [[rituximab]] as an induction therapy for Goodpasture's is not ideal because of its slow activation time. | *** The use of [[rituximab]] as an induction therapy for Goodpasture's is not ideal because of its slow activation time. | ||
==References== | ==References== | ||
Revision as of 22:28, 28 April 2018
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Goodpasture syndrome medical therapy On the Web |
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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.
- Plasmapheresis may still be of benefit in patients who present with pulmonary hemorrhage.[3]
- An alternative treatment used for Goodpasture's is rituximab.[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.