Renal, Urology and Electrolytesmiddle twist
A 42-year-old man presents with haemoptysis, fatigue and rapidly worsening renal function. Creatinine is 486 micromol/L, urine microscopy shows dysmorphic red cells and red-cell casts, and chest imaging shows bilateral alveolar infiltrates. Serum anti-glomerular basement membrane antibodies are strongly positive, while ANCA is negative. Which treatment is most appropriate?