Cargando…
Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male
Henoch-Schonlein purpura (HSP) frequently occurs in children under 15 years of age but is quite rare in adults. Most children who develop HSP nephritis completely recover from the illness, whereas up to 40% of adults have persistent hematuria and 10% develop chronic renal failure. Plasma exchange al...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2008
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421291/ https://www.ncbi.nlm.nih.gov/pubmed/25983918 http://dx.doi.org/10.1093/ndtplus/sfn106 |
_version_ | 1782369835693375488 |
---|---|
author | Chaudhary, Kunal Shin, Ji-Young Saab, Georges Luger, Alan M. |
author_facet | Chaudhary, Kunal Shin, Ji-Young Saab, Georges Luger, Alan M. |
author_sort | Chaudhary, Kunal |
collection | PubMed |
description | Henoch-Schonlein purpura (HSP) frequently occurs in children under 15 years of age but is quite rare in adults. Most children who develop HSP nephritis completely recover from the illness, whereas up to 40% of adults have persistent hematuria and 10% develop chronic renal failure. Plasma exchange alone has been shown to be beneficial in children who have HSP nephritis. Adults have been treated using immunosuppressive drugs such as cyclophosphamide but effects are not certain. Here, we present a case of a 59-year-old white male who developed HSP nephritis while undergoing treatment with steroids. The patient developed acute renal failure with proteinuria and hematuria ∼2 weeks after being initially diagnosed with HSP by skin biopsy. Renal biopsy showed proliferative, exudative glomerulonephritis involving all 20 glomeruli; some with early crescent formation. Immunofluorescence staining showed 3+ IgA deposits in mesangium suggesting HSP-induced GN. The patient's serum creatinine rose to 2.5 mg/dl with ∼5 g of proteinuria by dipstick. Steroids were continued and the patient received plasma exchange treatments. Due to a very low leukocyte count, immunosuppressive agents were not given. Subsequently, renal function improved and the creatinine level came down to 1.3 mg/dl and proteinuria to <1 g/24 h. Since then, 1 year after this event, his serum creatinine has continued to stay at 1.2 mg/dl and he has trace proteinuria while taking a low-dose ACE inhibitor. This case illustrates the usefulness of plasma exchange in adult onset HSP nephritis, even without concomitant use of cytotoxic agents. |
format | Online Article Text |
id | pubmed-4421291 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-44212912015-05-15 Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male Chaudhary, Kunal Shin, Ji-Young Saab, Georges Luger, Alan M. NDT Plus Case Report Henoch-Schonlein purpura (HSP) frequently occurs in children under 15 years of age but is quite rare in adults. Most children who develop HSP nephritis completely recover from the illness, whereas up to 40% of adults have persistent hematuria and 10% develop chronic renal failure. Plasma exchange alone has been shown to be beneficial in children who have HSP nephritis. Adults have been treated using immunosuppressive drugs such as cyclophosphamide but effects are not certain. Here, we present a case of a 59-year-old white male who developed HSP nephritis while undergoing treatment with steroids. The patient developed acute renal failure with proteinuria and hematuria ∼2 weeks after being initially diagnosed with HSP by skin biopsy. Renal biopsy showed proliferative, exudative glomerulonephritis involving all 20 glomeruli; some with early crescent formation. Immunofluorescence staining showed 3+ IgA deposits in mesangium suggesting HSP-induced GN. The patient's serum creatinine rose to 2.5 mg/dl with ∼5 g of proteinuria by dipstick. Steroids were continued and the patient received plasma exchange treatments. Due to a very low leukocyte count, immunosuppressive agents were not given. Subsequently, renal function improved and the creatinine level came down to 1.3 mg/dl and proteinuria to <1 g/24 h. Since then, 1 year after this event, his serum creatinine has continued to stay at 1.2 mg/dl and he has trace proteinuria while taking a low-dose ACE inhibitor. This case illustrates the usefulness of plasma exchange in adult onset HSP nephritis, even without concomitant use of cytotoxic agents. Oxford University Press 2008-10 2008-07-25 /pmc/articles/PMC4421291/ /pubmed/25983918 http://dx.doi.org/10.1093/ndtplus/sfn106 Text en © The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Report Chaudhary, Kunal Shin, Ji-Young Saab, Georges Luger, Alan M. Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male |
title | Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male |
title_full | Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male |
title_fullStr | Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male |
title_full_unstemmed | Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male |
title_short | Successful treatment of Henoch-Schonlein purpura nephritis with plasma exchange in an adult male |
title_sort | successful treatment of henoch-schonlein purpura nephritis with plasma exchange in an adult male |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421291/ https://www.ncbi.nlm.nih.gov/pubmed/25983918 http://dx.doi.org/10.1093/ndtplus/sfn106 |
work_keys_str_mv | AT chaudharykunal successfultreatmentofhenochschonleinpurpuranephritiswithplasmaexchangeinanadultmale AT shinjiyoung successfultreatmentofhenochschonleinpurpuranephritiswithplasmaexchangeinanadultmale AT saabgeorges successfultreatmentofhenochschonleinpurpuranephritiswithplasmaexchangeinanadultmale AT lugeralanm successfultreatmentofhenochschonleinpurpuranephritiswithplasmaexchangeinanadultmale |