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Warning-sign checks

Anti-glomerular basement membrane disease: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency care for coughing up blood, severe breathing difficulty, fainting, confusion, blue or gray lips, or little to no urine with rapidly worsening illness.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Between planned visits, contact the care team promptly for new blood in the urine, increasing swelling, falling urine output, fever during immune-suppressing treatment, or a return of cough or breathlessness.

  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up usually includes kidney function tests, urine testing, blood counts, and measurement of anti-GBM antibodies.

    The care team may also monitor ANCA when it was present at diagnosis.

    The schedule depends on disease severity, treatment, and whether kidney function has recovered.

    Routine visits are used to review blood pressure, swelling, urine output, breathing, medicine side effects, infection risk, and dialysis needs.

    People taking immune-suppressing medicines need planned laboratory monitoring and should not adjust treatment without medical advice.

    If kidney function does not recover, follow-up focuses on dialysis care, anemia, bone and mineral health, nutrition, blood pressure, and transplant planning when appropriate.

    Kidney transplantation may be possible after the disease becomes inactive.

    Specialists generally wait until anti-GBM antibodies have remained undetectable for a period of time before transplantation to reduce the risk of disease affecting the new kidney.

Every sign above is quoted from the sofidex article on Anti-glomerular basement membrane disease. If you are not sure, err upward — it is always reasonable to be checked.