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A Successful Treatment For Henoch-Schonlein Purpura Nephritis

Time:  2014-01-11 03:14

A Successful Treatment For Henoch-Schonlein Purpura Nephritis With Plasma ExchangePurpura Nephritis (also called Anaphylactoid Purpura Nephritis) is a kidney disease, which occurs when Henoch-Schonlein Purpura(HSP) causes kidney damages. HSP is a micro-vascular leukocytoclastic vasculitis which is characterized by deposition of immune complexes containing IgA. The immune complexes will trigger abnormal inflammation and damage functioning renal intrinsic cells. Plasma exchange is a method that removes plasma from the blood and replaces it with new plasma fluid. In this way, the harmful immune complexes building up in the blood will be removed. Thus, the progressive inflammations can be slowed down and Henoch-schonlein Purpura Nephritis can be alleviated or well controlled.

Henoch-Schonlein Purpura (HSP) frequently occurs in children who are under 15 years old but is rarely seen in adults. Most children with HSP nephritis completely recover from the illness, while up to 40% of adults have persistent hematuria and 10% develop chronic kidney failure. In clinic, those which is manifested as acute nephritis and with the presence of massive crescents have great risk of developing kidney failure. For this, patients may be recommended more active treatment besides steroid treatment such as plasma exchange treatment. It is researched that blood plasma exchange on HSP Purpura Nephritis patients have been proven therapeutic effects in remitting clinical manifestations and slowing down renal progression.

In a recent case, a 73-year-old man was admitted to our hospital because of hematuria, proteinuria, purpura and extremely edema. The medical data showed proteinuria 2.0g/day, hematuria 3+, serum creatinine 1.2mg/dl, total protein 6.3g/dl, and albumin 3.1 g/dl. He had a high fever with neutrophilia and rapid deterioration of renal function. On the basis of skin biopsy, we made a diagnosis of leukocytoclastic vasculitis with IgA deposition. Also oral prednisolone 40mg/day following drip intravenous methylprednisolone was applied to him. However, there was no sign of improvement of renal function and urinary findings. In this case, renal biopsy was used. Although there were no crescentic formation in the renal biopsy, most of the glomeruli showed thrombotic microangiopathy and endocapillary proliferation with IgA deposition and electron dense deposits. Therefore, a plasma exchange was applied which resulted in an improvement of the renal function. With improvement of kidney function. The serum creatinine level was lowered from 2.7 to 0.8mg/dl and proteinuria from 3.7 to 0.1 g/day. In the second biopsy, the electron dense deposits with an IgA deposition had disappeared. This case suggested that plasma exchange was effective in treatment of HSP nephritis.

Blood plasma exchange as an advanced technique holds promise for controlling progression of HSP and improving the prognosis in the patients. If you want to learn more about blood plasma exchange, you can read more blood plasma exchange on our website, or you can contact us for free.

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