Isolated Pulmonary Involvement in Anti-Glomerular Basement Membrane Disease

Homan, Michelle M.; Nazir, Usman; Schnell, Audrey H.; Williamson, Timothy

doi:10.1378/chest.2280919

Cited by 2 publications

(2 citation statements)

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“…In the present case, anti-GBM antibody was positive but had a relatively low titer. To our knowledge, there have been three cases of anti-GBM disease with isolated DAH in which antibody titers were lower than that in our case or undetectable ( 5 , 16 , 17 ). In one of the cases, the authors speculated that anti-GBM antibody existed solely in a tissue-bound form and was not detectable in the circulation ( 17 ).…”

Section: Discussioncontrasting

confidence: 76%

Rituximab for the Treatment of Anti-glomerular Basement Membrane Disease with Isolated Diffuse Alveolar Hemorrhage

et al. 2023

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Anti-glomerular basement membrane (GBM) disease with isolated diffuse alveolar hemorrhage (DAH) is rare. We herein report a 91-year-old man admitted with hypoxia and diagnosed with anti-GBM disease with DAH based on positive bronchoalveolar lavage and serum antibody test results. There was no renal involvement. Although remission was achieved using glucocorticoids and plasmapheresis, the patient experienced DAH relapse one week after the last plasmapheresis. Rituximab 375 mg/m 2 was administered 4 times weekly; thereafter, DAH relapse was not observed, and the glucocorticoid dosage was tapered. Rituximab was thus effective in treating anti-GBM disease with isolated DAH in an extremely elderly patient.

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Section: Discussioncontrasting

confidence: 76%

Rituximab for the Treatment of Anti-glomerular Basement Membrane Disease with Isolated Diffuse Alveolar Hemorrhage

et al. 2023

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“…However, before suspecting this, it would be prudent to evaluate all symptomatic patients for diffuse‐alveolar hemorrhage (DAH) and microscopic hematuria. Isolated pulmonary involvement is rare and while serum creatinine may be preserved initially, especially in young patients with good renal functional reserve, microscopic hematuria is a reliable clue to renal involvement. It is important to note that early diagnosis of anti‐GBM disease and treatment with plasmapheresis is associated with better prognosis.…”

Section: Casementioning

confidence: 99%