Hair Dye as a Potential Trigger for Relapse of Anti-GBM Disease: A Case Report

Anti-glomerular basement membrane (GBM) disease is usually a monophasic condition. Relapses are uncommon and linked to triggers like smoking, inhalation of solvents, hair dye, or infections. We report a 43-year-old male with biopsy-proven anti-GBM disease who was initially treated with plasmapheresis, steroids, and cyclophosphamide. After 2 months, following the use of a new hair dye, he developed diffuse alveolar hemorrhage with increased anti-GBM antibody titers. He was managed with plasmapheresis, intravenous immunoglobulins, and rituximab. This case highlights the importance of avoiding triggers and supports the role of rituximab in relapsing disease.