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Plasmapheresis for crescentic IgA nephropathy: A report of two cases and review of the literature
Author(s) -
Chambers Michael E.,
McDonald Brian R.,
Hall Frank W.,
Rabetoy Gary M.
Publication year - 1999
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/(sici)1098-1101(1999)14:4<185::aid-jca6>3.0.co;2-k
Subject(s) - plasmapheresis , medicine , nephropathy , glomerulonephritis , rapidly progressive glomerulonephritis , apheresis , renal function , uremia , proteinuria , end stage renal disease , disease , intensive care medicine , gastroenterology , immunology , kidney , endocrinology , antibody , platelet , diabetes mellitus
Idiopathic IgA nephropathy is widely regarded as a slowly progressive disease that not infrequently results in end‐stage renal failure. Only a minority of patients present with either a rapidly progressive form of glomerulonephritis, or with end‐stage renal failure. Anecdotal reports of improved renal function after treatment with plasmapheresis have been published, but the efficacy of this therapy remains controversial. We describe the course of two young males presenting with uremia, hypertension, nephrotic‐range proteinuria, and crescentic glomerulonephritis on renal biopsy. Both patients underwent therapy with steroids, immunosuppressive agents, and plasmapheresis without an appreciable improvement in renal function. A review of the literature does not offer any conclusive data to support the role of plasmapheresis in the treatment of rapidly progressive glomerulonephritis due to IgA nephropathy and points out the need to define criteria that may identify subsets of patients with this disorder who may potentially benefit from plasma exchange therapy. J. Clin. Apheresis 14:185–187, 1999. Published 1999 Wiley‐Liss, Inc.