Which combination constitutes first-line pharmaceutical therapy for Goodpasture's disease?

Which combination constitutes first-line pharmaceutical therapy for Goodpasture's disease?

• A. High dose corticosteroids + cyclophosphamide + plasmapheresis
• B. ACE inhibitors alone
• C. Anticoagulation therapy
• D. Dialysis without immunosuppression

Answer: (A)

Goodpasture's disease is an autoimmune attack where antibodies target the glomerular and alveolar basement membranes, so treatment must both remove the antibodies and stop their production. Plasmapheresis quickly clears circulating anti-GBM antibodies from the bloodstream, while high-dose corticosteroids reduce immune system inflammation, and cyclophosphamide suppresses the production of new antibodies by B cells. This combination directly addresses the ongoing immune attack and helps prevent progression to kidney failure and severe lung bleeding. Other approaches don’t tackle the autoimmune process: ACE inhibitors don’t remove antibodies, anticoagulation isn’t effective for this immune-mediated damage, and dialysis alone manages kidney failure without stopping antibody production or clearing circulating antibodies.

Goodpasture's disease is an autoimmune attack where antibodies target the glomerular and alveolar basement membranes, so treatment must both remove the antibodies and stop their production. Plasmapheresis quickly clears circulating anti-GBM antibodies from the bloodstream, while high-dose corticosteroids reduce immune system inflammation, and cyclophosphamide suppresses the production of new antibodies by B cells. This combination directly addresses the ongoing immune attack and helps prevent progression to kidney failure and severe lung bleeding. Other approaches don’t tackle the autoimmune process: ACE inhibitors don’t remove antibodies, anticoagulation isn’t effective for this immune-mediated damage, and dialysis alone manages kidney failure without stopping antibody production or clearing circulating antibodies.