The effect of frequent plasmapheresis in a patient with anti-glomerular basement membrane antibody diseases with severe renal dysfunction: a case report and literature review.

Anti-glomerular basement membrane antibody (anti-GBM) disease is a rare yet aggressive autoimmune disorder that affects the kidneys and lungs. Patients with renal involvement often progressed to death or end-stage renal disease. Treatment with plasmapheresis, along with cyclophosphamide and corticosteroids, has been suggested to improve renal and patient survival; however, it showed little benefit in patients who presented with severe disease. We herein report a critically ill case with anuria, creatinine value of 752 μmol/L, anti-GBM antibody titer of 92.54 RU/mL, and 96.7% fibro-cellular crescent formation at renal biopsy. The patient was diagnosed with anti-GBM disease and treated with plasmapheresis and immunosuppressive therapy. Plasmapheresis was not ceased until the total clearance of pathogenic autoantibodies. The patient's renal function was successfully rescued and maintained normal during the 5-year follow-up. Our experience implicated that early and persistent plasmapheresis could rescue the kidney function of anti-GBM patients who have extremely poor prognosis.