Effectiveness of Plasmapheresis in a Patient with Anti-glomerular Basement Membrane Antibody Glomerulonephritis with Advanced Kidney Dysfunction

Patients with anti-glomerular basement membrane antibody glomerulonephritis (anti-GBM GN) have severe kidney dysfunction, leading to end-stage renal disease. The effect of plasmapheresis and immunosuppressive treatment in patients with severe glomerular changes is controversial. A 62-year-old man wa...

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Published inInternal Medicine Vol. 56; no. 18; pp. 2475 - 2479
Main Authors Usui, Toshiaki, Kai, Hirayasu, Noguchi, Kazuyuki, Morito, Naoki, Usui, Joichi, Saito, Chie, Uesugi, Noriko, Nagata, Michio, Yamagata, Kunihiro
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2017
Japan Science and Technology Agency
Subjects
anti-glomerular basement membrane antibody glomerulonephritis
Anti-Glomerular Basement Membrane Disease - immunology
Anti-Glomerular Basement Membrane Disease - pathology
Anti-Glomerular Basement Membrane Disease - therapy
Autoantibodies - immunology
Basement membranes
Biopsy
Case Report
dialysis
End-stage renal disease
glomerular crescents
Glomerulonephritis
Hemodialysis
Humans
Immunosuppressive Agents - therapeutic use
Internal medicine
Kidney diseases
Kidney transplantation
Male
Medical treatment
Middle Aged
Patients
Plasmapheresis
Plasmapheresis - methods
Prognosis
Renal Dialysis
Renal function
dialysis
anti-glomerular basement membrane antibody glomerulonephritis
glomerular crescents
plasmapheresis
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Summary:Patients with anti-glomerular basement membrane antibody glomerulonephritis (anti-GBM GN) have severe kidney dysfunction, leading to end-stage renal disease. The effect of plasmapheresis and immunosuppressive treatment in patients with severe glomerular changes is controversial. A 62-year-old man was admitted with rapidly progressive glomerulonephritis and diagnosed with anti-GBM GN. He required hemodialysis. All glomeruli in the kidney biopsy specimen had cellular crescents without fibrotic changes, suggesting reversible damage. He was treated with plasmapheresis until the anti-glomerular basement membrane antibodies disappeared. His kidney function recovered, and dialysis was able to be discontinued. Frequent plasmapheresis in patients with dialysis-dependent anti-GBM GN may improve the kidney prognosis.
Bibliography:ObjectType-Case Study-2
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Correspondence to Dr.　Kunihiro Yamagata, k-yamaga@md.tsukuba.ac.jp
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.8571-16