Patients with Goodpasture's syndrome presenting with dialysis-dependent end
-stage renal failure at diagnosis almost never regain independent renal fun
ction. We report a patient with a 100% crescentic lesion in whom reversal o
f dialysis dependence was achieved by immunoadsorption together with immuno
suppression. In a second patient, early initiation of immunoadsorption was
able to completely restore normal renal function as early as 1 month after
the start of treatment. These data give evidence of the use of immunoadsorp
tion as a hopeful alternative to conventional plasma exchange in patients w
ith Goodpasture's syndrome showing advanced renal failure. (C) 2000 by the
National Kidney Foundation, Inc.