Plasmapheresis leading to remission of refractory nephrotic syndrome due to fibrillary glomerulonephritis: A case report

被引：6

作者：

Pliquett R.U. ^{[1
]}

Mohr P. ^{[1
]}

El Din Mukhtar B. ^{[2
]}

Girndt M. ^{[1
]}

Markau S. ^{[1
]}

机构：

[1] Department of Internal Medicine II, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, 06120 Halle (Saale)

[2] Dialysis Center, 06217 Merseburg

来源：

Journal of Medical Case Reports | / 6卷 / 1期

关键词：

Proteinuria; Nephrotic Syndrome; Valsartan; Mycophenolate Mofetil; Aliskiren;

D O I：

10.1186/1752-1947-6-116

中图分类号：

学科分类号：

摘要：

Introduction. Fibrillary glomerulonephritis (FibGN) is characterized by extracellular deposition of Congo red-negative microfibrils within the glomerular mesangium and leads to gross proteinuria or nephrotic syndrome. After diagnosis of FibGN, end-stage renal disease occurs within four years in 50% of patients. Case presentation. A 36-year-old Caucasian woman with proteinuria and intermittent nephrotic syndrome due to FibGN intermittently received immunosuppressive therapies, including glucocorticoids, mycophenolate mofetil, and rituximab, for 10 years. However, disease remission was not achieved and progressive kidney injury developed. Ultimately, in stage IV of chronic kidney disease (Kidney Disease: Improving Global Outcomes), three cycles of plasmapheresis of five to seven sessions each were performed every three to four months, reducing steady-state proteinuria from 7 to less than 1 g/day. Here, plasmapheresis led to a remission of nephrotic syndrome associated with FibGN. Conclusions: Plasmapheresis therapy is proposed as a further option for immunosuppressant-refractory FibGN. © 2012 Pliquett et al; licensee BioMed Central Ltd.

引用

共 11 条

[1]

Pronovost P.H., Brady H.R., Gunning M.E., Espinoza O., Rennke H.G., Clinical features, predictors of disease progression and results of renal transplantation in fibrillary/immunotactoid glomerulopathy, Nephrology Dialysis Transplantation, 11, 5, pp. 837-842, (1996)

[2]

Ray S., Rouse K., Appis A., Novak R., Haller N.A., Fibrillary glomerulonephritis with hepatitis C viral infection and hypocomplementemia, Ren Fail, 30, pp. 759-762, (2008)

[3]

Haas M., Rajaraman S., Ahuja T., Kittaka M., Cavallo T., Fibrillary/immunotactoid glomerulonephritis in HIV-positive patients: A report of three cases, Nephrol Dial Transplant, 15, pp. 1679-1683, (2000)

[4]

Dickenmann M., Schaub S., Nickeleit V., Mihatsch M., Steiger J., Brunner F., Fibrillary glomerulonephritis: Early diagnosis associated with steroid responsiveness, Am J Kidney Dis, 40, (2002)

[5]

Collins M., Navaneethan S.D., Chung M., Sloand J., Goldman B., Appel G., Rovin B.H., Rituximab treatment of fibrillary glomerulonephritis, Am J Kidney Dis, 52, pp. 1158-1162, (2008)

[6]

Javaid M.M., Denley H., Tagboto S., Fibrillary glomerulonephritis with small fibrils in a patient with the antiphospholipid antibody syndrome successfully treated with immunosuppressive therapy, BMC Nephrology, 8, (2007)

[7]

Strebl P., Tichy M., Krejci K., Al Jabry S., Horcicka V., Husek K., Vernerova Z., Zadrazil J., Fibrilární glomerulonefritida - Vzácná prícina nefrotického syndromu, Vnitrni Lekarstvi, 50, 8, pp. 624-627, (2004)

[8]

Nasr S.H., Valeri A.M., Cornell L.D., Fidler M.E., Sethi S., Leung N., Fervenza F.C., Fibrillary glomerulonephritis: A report of 66 cases from a single institution, Clin J Am Soc Nephrol, 6, pp. 775-784, (2011)

[9]

Levey A.S., Bosch J.P., Lewis J.B., Greene T., Rogers N., Roth D., A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation, Annals of Internal Medicine, 130, 6, pp. 461-470, (1999)

[10]

Sabatine M.S., Aretz H.T., Fang L.S., Dec G.W., Images in cardiovascular medicine. Fibrillary/immunotactoid glomerulopathy with cardiac involvement, Circulation, 105, (2002)

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