Apheresis to treat systemic vasculitis

被引:13
作者
Moussi-Frances, Julie [1 ]
Sallee, Marion [1 ,2 ,3 ]
Jourde-Chiche, Noemie [1 ,2 ,3 ]
机构
[1] Hop Conception, AP HM, Ctr Nephrol & Transplantat Renale, F-13005 Marseille, France
[2] Aix Marseille Univ, Fac Med, 27 Blvd Jean Moulin, F-13005 Marseille, France
[3] Aix Marseille Univ, Fac Pharm, UMRS Vasc Res Ctr Marseille 1076, 27 Blvd Jean Moulin, F-13005 Marseille, France
关键词
Apheresis; Plasma exchange; Immunoadsorption; Vasculitis; ANCA; Anti-GBM; Cryoglobulinemia; RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS; PROTEIN-A-IMMUNOADSORPTION; MEMBRANE ANTIBODY DISEASE; DIFFUSE ALVEOLAR HEMORRHAGE; THERAPEUTIC PLASMA-EXCHANGE; ANCA-ASSOCIATED VASCULITIS; CHURG-STRAUSS-SYNDROME; CRESCENTIC GLOMERULONEPHRITIS; GOODPASTURES-SYNDROME; RANDOMIZED-TRIAL;
D O I
10.1016/j.jbspin.2017.06.001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Apheresis has been used in the treatment of severe systemic vasculitides, in conjunction with immunosuppressive therapies, for over 40 years. The aim is to rapidly remove autoantibodies or circulating immune complexes from the plasma. The two main indications at present are vasculitis associated with Antineutrophil Cytoplasmic Antibodies (ANCAs) manifesting as severe renal involvement and/or intraalveolar hemorrhage and antiglomerular basement membrane disease (Goodpasture syndrome). The ongoing PEXIVAS randomized controlled trial is assessing plasmapheresis to treat ANCA-associated vasculitis with or without severe renal involvement or intraalveolar hemorrhage. The two main apheresis techniques used to treat systemic vasculitis are plasmapheresis (by filtration, centrifugation, or double filtration) and immunoadsorption. The advantages and drawbacks of each technique are discussed here. Whether one technique is superior over the other in the current indications has not been proven. (C) 2017 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:177 / 183
页数:7
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