Rituximab for Anti–Glomerular Basement Membrane Disease

Anti–glomerular basement membrane (GBM) disease, characterized by antibodies against the NC1 domain of type IV collagen, presents with rapidly progressive glomerulonephritis that advances quickly to end-stage renal disease if not identified and treated in a timely fashion. Pulmonary involvement, caused by autoantibodies targeting the alveolar basement membrane, occurs in 60% to 80% of patients1 and presents as alveolar hemorrhage. The renal histopathology of anti-GBM glomerulonephritis typically shows a necrotizing and crescentic lesion on light microscopy with linear deposits of IgG along the glomerular basement membrane on immunofluorescence microscopy.