What is your approach for induction therapy in dual positive anti-GBM/PR3 disease with ESRD presenting with recurrent DAH previously treated with cyclophosphamide?

Most patients who are double positive for ANCA and anti-GBM antibodies relapse with AAV rather than anti-GBM disease. The rate of relapse in single positive anti-GBM disease is very low, estimated at around 2% by some experts. This is in contrast to double-positive patients who have a relapse rate s...