A patient with Goodpasture's disease may benefit from plasmapheresis or plasma exchange.


Goal: to quickly reduce anti-GBM antibodies


Pulmonary hemorrhage is a key indication for plasmapheresis.


Treatment usually involves:

(1) daily for plasmapheresis sessions 8 to 14 days

(2) concurrent therapy with oral prednisone and cyclophosphamide, which is continued for weeks or months after completing the plasmapheresis


Factors associated with a better outcome"

(1) mild to moderate renal disease

(2) rapid response to therapy


Factors associated with a worse outcome:

(1) dialysis-dependent at presentation

(2) advanced disease on kidney biopsy


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