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PubMed This is a summary of 66 peer-reviewed journal articles Updated
Nephrology · Anti-Glomerular Basement Membrane Disease

Anti-GBM Disease (Goodpasture Disease): A Patient Guide

At a Glance

Anti-GBM disease (Goodpasture disease) can rapidly damage the lungs and kidneys. Urgent plasma exchange, high-dose steroids, and immune-suppressing medicine remove harmful antibodies and limit new ones; recovery depends largely on organ damage at diagnosis and whether ANCA antibodies are also present.

Anti-GBM disease, historically known as Goodpasture disease, is an exceptionally rare autoimmune condition that typically arrives as a sudden medical emergency. It occurs when the immune system mistakenly produces antibodies that attack the basement membranes—specialized structures that line the small blood vessels of the kidneys and the air sacs of the lungs [1][2]. This attack targets a specific protein called Type IV collagen. Because this protein is present in the basement membranes of the kidneys and lungs, the disease often presents as a “pulmonary-renal syndrome,” causing rapid inflammation that can compromise breathing and kidney filtration within a matter of days or weeks [3][4].

Because the damage can be aggressive and swift, the first priority of medical care is to rapidly stop the immune attack. For many patients, specialists use an intensive “triple therapy” approach, which combines plasmapheresis (plasma exchange) to physically remove the harmful antibodies from the blood with high-dose steroids and immunosuppressant medications to stop the body from producing new ones [5][6]. However, treatment is always individualized; your medical team will tailor the intensity of these treatments based on your kidney biopsy results, lung involvement, and the risks of serious infections or bleeding. For many patients, this initial phase requires immediate hospitalization and, in some cases, the use of a dialysis machine to perform the work of the kidneys while the inflammation is being brought under control [7]. The speed at which treatment begins is critical to preserving organ function [8].

The long-term outlook for Anti-GBM disease is heavily influenced by two factors: how advanced the disease was at the moment of diagnosis and the specific “fingerprint” of the antibodies involved. While many patients with “classic” Anti-GBM disease experience a one-time event that does not frequently return, a significant number of people are “double-positive,” meaning they also carry ANCA antibodies [9]. This subtype behaves differently and requires more prolonged monitoring because it carries a higher risk of the disease flaring up again in the future [10].

Living with Anti-GBM disease involves navigating the transition from an acute crisis to a period of recovery and specialized monitoring. For those whose kidneys are permanently scarred, the focus shifts toward managing chronic kidney disease or preparing for a future kidney transplant, which typically has excellent outcomes once the antibodies have remained undetectable for at least six months [11][12]. Despite the intensity of the diagnosis, the ultimate goal of your care team is to stabilize your immune system, minimize the side effects of medications, and provide a path toward long-term health and stability [2].

In this guide

6 chapters

01

Understanding Your Diagnosis: Anti-GBM Disease

Learn what anti-GBM disease means, why it can affect the kidneys and lungs, and how plasma exchange, steroids, immunosuppressants, and biopsy guide care.

02

Symptoms and Emergency Warning Signs

Learn the urgent symptoms of Anti-GBM disease, including coughing blood, breathing trouble, reduced urination, swelling, fever, and when to seek emergency care.

03

The Biology and Subtypes of Anti-GBM Disease

Learn how anti-GBM disease targets type IV collagen, why ANCA double-positive disease can relapse, and how subtype affects monitoring and treatment plans.

04

Diagnosing Anti-GBM Disease: Labs and Biopsies

Learn how anti-GBM disease is diagnosed through antibody blood tests and kidney biopsy findings, including linear IgG staining, crescents, and chronic scarring.

05

Standard Treatments and Managing Risks

Learn how anti-GBM disease is treated with plasma exchange, steroids, and immunosuppressants, plus how doctors monitor infection, fertility, and side effects.

06

Prognosis and Long-Term Health

Learn about Anti-GBM disease prognosis, kidney recovery, dialysis, relapse monitoring, and when a kidney transplant may be considered after antibodies clear.

Common questions in this guide

What is Anti-GBM disease, and is it the same as Goodpasture disease?
Anti-GBM disease is a rare autoimmune condition in which the immune system makes antibodies that attack specialized linings in the kidneys and lungs. Goodpasture disease is the historical name for this condition. The attack can quickly affect breathing and kidney filtering, so it may require emergency hospital treatment.
What treatment is used for Anti-GBM disease?
Treatment often begins in the hospital and may combine plasma exchange, high-dose steroids, and an immune-suppressing medicine. Plasma exchange removes harmful antibodies from the blood, while the medicines help stop the body from making more. Some people need dialysis temporarily if their kidneys cannot filter blood well.
How does the kidney biopsy affect my treatment or prognosis?
Doctors use the biopsy results, kidney function, and lung involvement to judge how advanced the disease is and tailor treatment. More advanced kidney damage is less likely to fully recover, and some people may need ongoing chronic kidney care, dialysis, or transplant planning.
What does it mean to be double-positive for Anti-GBM and ANCA antibodies?
Double-positive means that blood tests find both Anti-GBM antibodies and ANCA antibodies. This form can have a higher chance of flaring again than classic Anti-GBM disease, so it generally requires longer-term monitoring.
Can Anti-GBM disease come back after treatment?
Classic Anti-GBM disease is often a one-time event and does not frequently return. People who are also ANCA-positive have a higher risk of future flares, so follow-up antibody testing and specialist monitoring are important.
Can my kidneys recover, and when is a transplant considered?
Kidney recovery depends largely on how much damage was present when treatment began and what the biopsy shows. If the kidneys are permanently scarred, care may focus on chronic kidney disease, dialysis, or a kidney transplant; transplant outcomes are typically excellent after antibodies have remained undetectable for at least six months.
How can I reduce infection risk during Anti-GBM treatment?
High-dose steroids and immunosuppressant medicines weaken immune defenses, making serious infections an important treatment risk. Your healthcare team can create a prevention and monitoring plan tailored to your medicines and explain which symptoms require urgent contact.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Am I 'double-positive' for both anti-GBM and ANCA antibodies, and how does that change my long-term outlook?
  2. 2.Based on my biopsy and kidney function, what is the likelihood that my kidneys will recover, and what is our plan if they do not?
  3. 3.What specific steps are we taking to protect me from infections while my immune system is suppressed?
  4. 4.How often will I need to have my antibody levels checked after I leave the hospital?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (12)
  1. 1

    Anti-glomerular basement membrane disease-treatment standard.

    McAdoo SP, Pusey CD

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2025; (41(1)):42-54 doi:10.1093/ndt/gfaf190.

    PMID: 40973182
  2. 2

    Anti-glomerular basement membrane disease: A contemporary case series from a large university hospital center.

    Catarina Oliveira A, Figueiredo R, Correia R, et al.

    Nefrologia 2026; (46(7)):501522 doi:10.1016/j.nefroe.2026.501522.

    PMID: 42618193
  3. 3

    Autoimmunity in Anti-Glomerular Basement Membrane Disease: A Review of Mechanisms and Prospects for Immunotherapy.

    Kuang H, Liu J, Jia XY, et al.

    American journal of kidney diseases : the official journal of the National Kidney Foundation 2023; (81(1)):90-99 doi:10.1053/j.ajkd.2022.07.006.

    PMID: 36334986
  4. 4

    Goodpasture syndrome and anti-glomerular basement membrane disease.

    Reggiani F, L'Imperio V, Calatroni M, et al.

    Clinical and experimental rheumatology 2023; (41(4)):964-974 doi:10.55563/clinexprheumatol/tep3k5.

    PMID: 36995324
  5. 5

    Outcome of rituximab treatment in children with non-dialysis-dependent anti-GBM disease.

    Klaus R, Kanzelmeyer N, Haffner D, Lange-Sperandio B

    Pediatric nephrology (Berlin, Germany) 2025; (40(2)):423-430 doi:10.1007/s00467-024-06512-4.

    PMID: 39320552
  6. 6

    Immunity in the balance: Fatal disseminated adenovirus infection in a patient undergoing plasma exchange and immunosuppressive chemotherapy for anti-glomerular basement membrane disease.

    Jacobs JW, Figueroa Villalba CA, Stendahl K, et al.

    Journal of clinical apheresis 2023; (38(6)):770-777 doi:10.1002/jca.22088.

    PMID: 37698143
  7. 7

    Predictors of renal and patient outcomes in anti-GBM disease: clinicopathologic analysis of a two-centre cohort.

    Alchi B, Griffiths M, Sivalingam M, et al.

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015; (30(5)):814-21 doi:10.1093/ndt/gfu399.

    PMID: 25609740
  8. 8

    Plasmapheresis, immunosuppressive therapy and anti-GBM disease prognosis: a cohort study of 107 patients.

    Liu Y, Wu Y, Wei W, et al.

    Renal failure 2024; (46(2)):2400539 doi:10.1080/0886022X.2024.2400539.

    PMID: 39258391
  9. 9

    Patients double-seropositive for ANCA and anti-GBM antibodies have varied renal survival, frequency of relapse, and outcomes compared to single-seropositive patients.

    McAdoo SP, Tanna A, Hrušková Z, et al.

    Kidney international 2017; (92(3)):693-702 doi:10.1016/j.kint.2017.03.014.

    PMID: 28506760
  10. 10

    Recurrent Nephritis and/or Pulmonary Hemorrhage in Patients with Anti-Glomerular Basement Membrane Disease with and without ANCA Positivity.

    Droz N, Katz A, Patel A, et al.

    Glomerular diseases 2021; (1(2)):60-67 doi:10.1159/000515388.

    PMID: 36751425
  11. 11

    Outcomes After Kidney Transplantation in Antiglomerular Basement Membrane Disease.

    Traversat P, Dekervel M, Masset C, et al.

    Kidney international reports 2025; (10(9)):3150-3163 doi:10.1016/j.ekir.2025.06.021.

    PMID: 40980652
  12. 12

    Recurrence of Goodpasture syndrome without circulating anti-glomerular basement membrane antibodies after kidney transplant, a case report.

    Thibaud V, Rioux-Leclercq N, Vigneau C, Morice S

    BMC nephrology 2019; (20(1)):6 doi:10.1186/s12882-018-1197-6.

    PMID: 30621605

This page is for informational purposes only and does not constitute medical advice. Anti-GBM disease can worsen quickly; follow your healthcare team's guidance for urgent treatment and ongoing monitoring.

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