Successful induction of remission in anti-glomerular basement membrane (anti-GBM) glomerulonephritis can be obtained by using rituximab as a first-line immunosuppressive agent. We report the case of a 20-year-old male patient with Goodpasture's (anti-GBM) syndrome, with poor prognostic factors at presentation including intra-alveolar hemorrhage and dialysis-dependent rapidly progressive glomerulonephritis. The diagnosis was confirmed on kidney biopsy and serology (anti-GBM antibody titer). Rituximab was used as the first-line immunosuppressive agent in combination with pulse corticosteroids and plasmapheresis, to avoid potential side effects of cyclophosphamide. Anti-GBM antibody titers became undetectable after initiating rituximab. No adverse events were reported, and the patient became dialysis-independent after 6 months. This case reports the successful remission of a patient with Goodpasture's syndrome after induction with rituximab.
Keywords: Anti-GBM disease; Goodpasture’s syndrome; Plasmapheresis; Rapidly progressive glomerulonephritis with pulmonary hemorrhage; Rituximab.
© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.