A case of rapidly progressing glomerulonephritis due to double-positive anti-neutrophil cytoplasmic antibodies and anti-glomerular basement membrane antibodies vasculitis associated with membranous nephropathy treated with selective plasma exchange

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  • Hoshi Kenta
    Department of Nephrology, Endocrinology and Metabolism, Sano Kosei General Hospital
  • Urai Hidenori
    Department of Nephrology, Endocrinology and Metabolism, Sano Kosei General Hospital
  • Watanobe Osamu
    Department of Nephrology, Endocrinology and Metabolism, Sano Kosei General Hospital
  • Nakamura Akira
    Department of Nephrology, Endocrinology and Metabolism, Sano Kosei General Hospital
  • Hashiguchi Akinori
    Department of Pathology, School of Medicine, Keio University
  • Murakami Marohito
    Department of Nephrology, Endocrinology and Metabolism, Sano Kosei General Hospital

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Other Title
  • MPO-ANCA，抗GBM抗体共陽性かつ膜性腎症を合併した急速進行性糸球体腎炎に対して選択的血漿交換（SePE）を行った一例
  • MPO-ANCA,コウGBM コウタイ キョウ ヨウセイ カツ マクセイジンショウ オ ガッペイ シタ キュウソク シンコウセイ シキュウタイジンエン ニ タイシテ センタクテキ ケッショウ コウカン(SePE)オ オコナッタ イチレイ

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Abstract

<p>Rapidly progressing glomerulonephritis (RPGN) due to double-positive anti-neutrophil cytoplasmic antibodies and anti-glomerular basement membrane antibodies vasculitis is characterized by advanced renal damage, poor renal prognosis, and a high probability of relapse. The disease progression is rapid, and prompt therapeutic intervention, including plasma exchange therapy, is important. We report a case of selective plasma exchange (SePE) in addition to oral corticosteroid and cyclophosphamide pulse therapy (IVCY) for RPGN in a patient with crescentic glomerulonephritis. A 79-year-old woman was treated with oral corticosteroids, IVCY, and SePE. We suggest that early immunosuppressive therapy with SePE, which does not require coagulation factor replacement, may be useful in suppressing new antibody production and eliminating antibodies. </p>

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