Abstract | BACKGROUND: STUDY DESIGN: Case series. SETTING & PARTICIPANTS: 11 consecutive patients with severe and newly diagnosed HSP since 1988 who were treated with steroids and PE. OUTCOME & MEASUREMENT: Patients' characteristics and outcome were analyzed. Birmingham Vasculitis Activity Score (BVAS), estimated glomerular filtration rate (eGFR), and proteinuria were measured at baseline, at the end of PE treatment, at months 6 and 12, and at the last visit. Side effects of corticoid treatment and PE were recorded. RESULTS: 11 patients were identified in 1988-2010. Patients received intravenous corticoid pulses in 64% of cases, followed by oral prednisone for a median of 6.6 months. They received a median of 12 PE sessions. BVAS, eGFR, and proteinuria improved significantly between baseline and the last PE at a median of 2 months. PE sessions were well tolerated, except in one patient who developed central catheter-associated septicemia. One patient required dialysis therapy 15 days after HSP diagnosis and did not recover kidney function. At the last medical evaluation at a mean follow-up of 6 years, median eGFR and proteinuria were 83 ± 22 mL/min/1.73 m(2) and protein excretion of 140 ± 10 mg/d, respectively. 3 women had pregnancy without complications. LIMITATIONS: This case series did not have a control group. CONCLUSIONS: The combination of PE and corticoid therapy in severe forms of HSP was associated with fast improvement and good long-term outcome.
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Authors | Jean-François Augusto, Johnny Sayegh, Laurence Delapierre, Anne Croue, Fréderic Tollis, Maud Cousin, Jean-François Subra |
Journal | American journal of kidney diseases : the official journal of the National Kidney Foundation
(Am J Kidney Dis)
Vol. 59
Issue 5
Pg. 663-9
(May 2012)
ISSN: 1523-6838 [Electronic] United States |
PMID | 22300649
(Publication Type: Case Reports, Clinical Trial, Journal Article)
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Copyright | Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
(physiology)
- Glucocorticoids
(therapeutic use)
- Humans
- IgA Vasculitis
(physiopathology, therapy)
- Male
- Middle Aged
- Plasma Exchange
- Proteinuria
(physiopathology)
- Retrospective Studies
- Treatment Outcome
- Young Adult
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