Figure 3 (C) Strong linear ribbon-like appearance IgG (2+) in the GBM,
the glomerulus is compressed by a crescent, which does not stain (Direct
immunofluorescence on frozen kidney tissue, x200).
The patient was kept on plasmapheresis, hemodialysis, Cyclophosphamide
while steroids were switched to oral with tapering down after five days
of intravenous pulse steroids.
A few days later, the patient showed significant improvement in his
clinical condition and laboratory tests. His renal function improved,
and symptoms were resolved, so hemodialysis frequency was reduced. His
weekly titter of anti-GBM antibody was steadily declining with
plasmapheresis. After three weeks, the measured titter dropped from 500
U/mL to 7 U/mL. Plasmapheresis was stopped while he was kept on regular
hemodialysis three times per week in addition to Cyclophosphamide 100 mg
daily.