McAdoo et al. propose that patients with both circulating antiglomerular basement membrane antibody and antineutrophil cytoplasm antibody demonstrate a phenotype that lies between that of single-positive antiglomerular basement membrane disease and antineutrophil cytoplasm antibody-associated vasculitis. Specifically, there may be a subset of "double-positives" that have a more favorable response to therapy. These observations, along with reports of "atypical" antiglomerular basement membrane disease, challenge us to look beyond antiglomerular basement membrane disease as a 1-dimensional entity, and better characterize its clinical spectrum.
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