Plasmapheresis in the treatment of steroid-resistant focal segmental glomerulosclerosis.

Abstract

A patient presented with a severe nephrotic syndrome and a renal biopsy consistent with early focal segmental glomerulosclerosis (FSGS). After a year of intensive immunosuppressive therapy proteinuria was unabated and renal function began to deteriorate. Treatment with weekly plasmapheresis combined with moderate doses of prednisone and azathioprine produced a dramatic decrease in proteinuria and serum creatinine. A marked fall in the B-cell population occurred during treatment, as well as an increase both in T-lymphocytes of the mature CD4+ helper/suppressor phenotype and in the immature/cytotoxic CD8+ phenotype. Activation of the immune system during treatment was demonstrated by an increase in the rate of spontaneous proliferation of peripheral blood mononuclear cells and an increase in T-cell expression of the interleukin-2 receptor.

• Authors: D S Ginsburg, P Dau
• Journal: Clinical nephrology (Clin Nephrol) Vol. 48 Issue 5 Pg. 282-7 (Nov 1997) ISSN: 0301-0430 [Print] Germany
• PMID: 9403211 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Steroids

Topics

• Adult
• Drug Resistance
• Female
• Glomerulosclerosis, Focal Segmental (drug therapy, immunology, therapy)
• Humans
• Immunophenotyping
• Immunosuppressive Agents (therapeutic use)
• Lymphocyte Subsets (immunology)
• Plasmapheresis
• Proteinuria (therapy)
• Steroids (therapeutic use)