Low-density lipoprotein apheresis for proteinuria in lupus nephritis with intraglomerular foam cells containing cholesterol crystals.

Abstract

A 28-year-old woman with systemic lupus erythematosus was referred to our hospital due to nephrotic-level proteinuria despite approximately 1 year of treatment with 50 to 60 mg/d of prednisolone and 100 to 150 mg/d of cyclosporine with methylprednisolone pulse therapy. Kidney biopsy showed diffuse global lupus nephritis (World Health Organization class 4-G A/C) with many intraglomerular foam cells containing cholesterol crystals. Surprisingly, proteinuria diminished after only 5 low-density lipoprotein (LDL) cholesterol apheresis sessions. This case demonstrated the potential of LDL apheresis to exhibit a remarkable effect on not only focal segmental glomerulosclerosis, but also other types of nephritis, particularly nephritis with intraglomerular foam cells.

• Authors: Naoki Shiraishi, Kenichiro Kitamura, Manabu Hayata, Tomohiro Ogata, Keiko Tajiri-Okamura, Yushi Nakayama, Yukimasa Kohda, Kimio Tomita, Masashi Mukoyama
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 65 Issue 3 Pg. 490-3 (Mar 2015) ISSN: 1523-6838 [Electronic] United States
• PMID: 25542412 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Lipoproteins, LDL
• Cholesterol

Topics

• Adult
• Blood Component Removal
• Cholesterol (analysis)
• Crystallization
• Female
• Foam Cells (chemistry, pathology)
• Humans
• Kidney Glomerulus (chemistry, pathology)
• Lipoproteins, LDL (administration & dosage)
• Lupus Nephritis (complications, diagnosis, therapy)
• Proteinuria (complications, diagnosis, therapy)