Treatments for Goodpasture syndrome
Treatments for Goodpasture syndrome
The list of treatments mentioned in various sources
for Goodpasture syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Discussion of treatments for Goodpasture syndrome:
Goodpasture syndrome is treated with immunosuppressive drugs given by
mouth to keep the immune system from making antibodies. Corticosteroids
may be given intravenously to control bleeding in the lungs. A process
called plasmapheresis (PLAZ-ma-fer-REE-sis) may be helpful and necessary
to filter the harmful antibodies from the blood; this is usually done in
combination with the steroid treatment.
(Source: excerpt from
Goodpasture Syndrome: NIDDK)
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Hematuria:
Treatment
(In a Page: Signs and Symptoms)
-
Older patients with transient hematuria should always be evaluated due to increased risk of urinary tract cancers; refer to urologist for further evaluation and treatment
-
UTI: Start appropriate antibiotics and follow up with urinalysis to see if hematuria resolves
-
Glomerular sources (RBC casts, protein excretion >500 mg/dL, dysmorphic RBCs): Follow BUN/creatinine, blood pressure, creatinine clearance, and 24-hour urine protein, and refer for biopsy if worsening
-
Nonglomerular source (no RBC casts or dysmorphic RBCs in the urine): Urologic consult if imaging indicates a lesion (renal, bladder, or urethral)
-
Stones: Increase hydration, analgesics, urology referral for large or persistent stones
-
Myoglobinuria/hemoglobinuria: Treat underlying cause
-
Beeturia: Evaluate for iron deficiency or achlorhydria due to pernicious anemia, as treating these disorders may eliminate beeturia; eating foods high in oxalate (spinach, oysters) with beets can also cause beeturia
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Purpura:
Treatment
(In a Page: Signs and Symptoms)
-
Discontinue causative medications
-
Correct coagulopathies as necessary
-
Treat malignancy as necessary
-
Sun protection and avoidance of trauma will prevent actinic and age-related purpura
-
Treat stasis-associated lower extremity purpura with compression stockings, elevation, and diuretics if edema is present
-
Infections: Prompt antimicrobial treatment (e.g., doxycycline for RMSF, ceftriaxone for meningococcemia) is imperative to prevent mortality
-
Autoimmune diseases: High-dose corticosteroids followed by steroid-sparing medications (e.g., methotrexate, cyclosporine, azathioprine, mycophenolate mofetil) for long-term treatment
-
Idiopathic pigmented purpuras are most common on the lower legs of men, and may resolve spontaneously or persist indefinitely; high potency topical steroids and oral vitamin C sometimes hasten their resolution
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hematuria:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
UTI: Empiric antibiotic (e.g., co-trimoxazole)
-
Manage hypertension
–ACE inhibitors or calcium channel blockers
–Consider diuretics if edematous
-
Suspected acute glomerulonephritis
–Low C3, evidence of recent strep or other infection
–Monitor urine output, weight, BP closely
–Daily outpatient visits until stable
–Inpatient admission if oliguria/edema is severe
–Once acute phase is over, monitor every 1–2 weeks and recheck C3 in 6–8 weeks
-
Nephrolithiasis: Increase fluid intake
–Sodium-restrict (do not calcium-restrict)
–Consult urology for severe pain or obstruction
-
Consult nephrology if hematuria persists or is associated with proteinuria, hypertension, persistently decreased C3, or abnormal creatinine
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Purpura:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- HSP: Analgesia, hydration, treat complications
–Corticosteroid use is controversial
- ITP with platelet count <20,000
–IV immunoglobulin to block macrophage receptors
–Anti-Rh immunoglobulin binds to RBCs so the spleen destroys RBCs instead of platelets, corticosteroids
–Treat to raise platelet count and decrease risk of
intracranial hemorrhage
–Emergency: Platelet transfusion
–Chronic: Immunosuppressant or splenectomy
-
Hemophilia A: Recombinant F VIII
–IV or intranasal DDAVP (desmopressin) releases F VIII and vWF from endothelial cells
-
Hemophilia B: Recombinant or plasma-derived F IX
-
DIC: Treat cause; transfuse platelets, cryoprecipitate, or fresh frozen plasma
- vWD: DDAVP or plasma-derived vWF
-
PAN: Oral or IV corticosteroid
>>>>>>>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Goodpasture's syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment aims to remove antibody by plasmapheresis and to suppress antibody production with immunosuppressive drugs, such as cyclophosphamide, to stop attacks by immune cells on the kidneys and lungs. Patients with renal failure may benefit from dialysis or transplantation. Aggressive ultrafiltration helps relieve pulmonary edema that may aggravate pulmonary hemorrhage. High-dose I.V. steroids also help control pulmonary hemorrhage.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Allergic purpuras:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment is generally symptomatic; for example, severe allergic purpura may require steroids to relieve edema and analgesics to relieve joint and abdominal pain. Some patients with chronic renal disease may benefit from immunosuppressive therapy with azathioprine along with identification of the provocative allergen. An accurate allergy history is essential.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Idiopathic thrombocytopenic purpura:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Acute ITP may be allowed to run its course without intervention or may be treated with glucocorticoids or immune globulin. For chronic ITP, corticosteroids may be the initial treatment of choice. Patients who fail to respond within 1 to 4 months or who need high steroid dosage are candidates for splenectomy, which may be successful in 50% of cases. Alternative treatments include immunosuppression, high-dose gamma globulin injections, and immunoabsorption apheresis using staphylococcal protein-A columns, which filter antibodies out of the bloodstream. Anti-RhD therapy can also be useful in people with specific blood types.
Before splenectomy, the patient may require blood, blood components, and vitamin K to correct anemia and coagulation defects. After splenectomy, he may need blood and component replacement and platelet concentrate. Normally, platelets increase spontaneously after splenectomy.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Premature rupture of membranes:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment for PROM depends on fetal age and the risk of infection. In a term pregnancy, if spontaneous labor and vaginal delivery aren’t achieved within a relatively short time (usually within 24 hours after the membranes rupture), induction of labor with oxytocin is usually required; if induction fails, cesarean delivery is usually necessary. Cesarean hysterectomy is recommended with gross uterine infection.
Management of a preterm pregnancy of less than 34 weeks is controversial. However, with advances in technology, a conservative approach to PROM has now been proven effective. With a preterm pregnancy of 28 to 34 weeks, treatment includes hospitalization and observation for signs of infection (maternal leukocytosis or fever, and fetal tachycardia) while awaiting fetal maturation. If clinical status suggests infection, baseline cultures and sensitivity tests are appropriate. If these tests confirm infection, labor must be induced, followed by I.V. administration of antibiotics. A culture should also be made of gastric aspirate or a swabbing from the neonate’s ear because antibiotic therapy may be indicated for him as well. At such delivery, have resuscitative equipment available to treat neonatal distress.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hematuria:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Teach the patient how to collect serial urine specimens using the three-glass technique. This technique helps determine whether hematuria marks the beginning, end, or entire course of urination.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Allergic purpura:
Treatment
(Handbook of Diseases)
Most patients with Henoch-Schönlein syndrome recover completely. When therapy is required, the glucocorticoid prednisone is given in doses of 1 mg/kg, and tapered to response, to relieve edema. An analgesic may be given to relieve joint and abdominal pain. Some patients with chronic renal disease may benefit from intensive plasma exchange combined with an immunosuppressant, along with identification of the provocative allergen. An accurate allergy history is essential.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Idiopathic thrombocytopenic purpura:
Treatment
(Handbook of Diseases)
Acute ITP may be allowed to run its course without intervention or may be treated with a glucocorticoid or immune globulin. For chronic ITP, a corticosteroid may be the initial treatment of choice. Patients who fail to respond within 1 to 4 months or who need high steroid dosage are candidates for splenectomy, which has an 85% success rate. Alternative treatments include immunosuppression, high-dose I.V. gamma globulin, and immunoabsorption apheresis using staphylococcal protein-A columns.
Clinical tip Before splenectomy, the patient may require blood, blood components, or vitamin K to correct anemia and coagulation defects. After splenectomy, he may need blood and component replacement and platelet concentrate. Normally, platelets increase spontaneously after splenectomy.
The patient may find complementary therapies to be helpful. He may explore such therapies with his physician.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Premature rupture of the membranes:
Treatment
(Handbook of Diseases)
Treatment of PROM depends on fetal age and the risk of infection. In a full- term pregnancy, if spontaneous labor and vaginal delivery aren’t achieved within a relatively short time (usually within 24 hours after the membranes rupture), induction of labor with oxytocin is usually required; if induction fails, cesarean delivery is usually necessary. Cesarean hysterectomy is recommended if the patient is experiencing gross uterine infection.
Management of a preterm pregnancy of less than 34 weeks is controversial. However, with advances in technology, a conservative approach to PROM has now been proven effective.
With a preterm pregnancy of 28 to 34 weeks, treatment includes hospitalization and observation for signs of infection (maternal leukocytosis or fever and fetal tachycardia) while awaiting fetal maturation.
If clinical status suggests infection, baseline cultures and sensitivity tests are appropriate. If these tests confirm infection, labor must be induced, followed by I.V. administration of antibiotics. A culture should also be made of gastric aspirate or a swabbing from the neonate’s ear because antibiotic therapy may be indicated for the neonate as well. In such deliveries, have resuscitative equipment available to treat neonatal distress.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hematuria:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient how to collect serial urine specimens using the three-glass technique. This technique helps determine whether hematuria marks the beginning, end, or entire course of urination. Encourage the patient to drink plenty of fluids, unless contraindicated.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Purpura:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Reassure the patient that purpuric lesions aren’t permanent and will fade if the underlying cause can be successfully treated. Warn him not to use cosmetic fade creams or other products in an attempt to reduce pigmentation
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hematuria:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Check vital signs frequently.
▪ Monitor intake and output, including the amount and pattern of hematuria.
▪ If the patient has an indwelling urinary catheter in place, ensure its patency and irrigate it if necessary to remove clots and tissue that may impede urine drainage.
▪ Administer prescribed analgesics, and enforce bed rest as indicated.
▪ Prepare the patient for diagnostic tests, such as blood and urine studies, cystoscopy, and renal X-rays or biopsy.
▪ Monitor hemoglobin level and hematocrit; administer blood products as ordered.
Patient teaching
▪ Show the patient how to collect urine specimens.
▪ Emphasize the need to increase fluid intake.
▪ Explain the underlying cause of hematuria and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Purpura:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, including a peripheral blood smear, bone marrow examination, and blood tests to determine platelet count, bleeding and coagulation times, capillary fragility, clot retraction, prothrombin time, partial thromboplastin time, and fibrinogen levels.
▪ If the patient has a hematoma, apply pressure and cold compresses initially to help reduce bleeding and swelling. After the first 24 hours, apply hot compresses to help speed blood absorption.
Patient teaching
▪ Explain the underlying cause and treatment plan.
▪ Reassure the patient that purpuric lesions aren't permanent and will fade if the underlying cause can be successfully treated.
▪ Warn the patient not to use cosmetic fade creams or other products in an attempt to reduce pigmentation.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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