Treatment of rapidly progressive anti-GBM antibody-type glomerulonephritis with combination therapy involving simple plasma exchange and selective plasma exchange: a case report

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  • 単純血漿交換と選択的血漿交換の混合療法で治療した抗GBM抗体型急速進行性糸球体腎炎の1例
  • 症例報告 単純血漿交換と選択的血漿交換の混合療法で治療した抗GBM抗体型急速進行性糸球体腎炎の1例
  • ショウレイ ホウコク タンジュン ケッショウ コウカン ト センタクテキ ケッショウ コウカン ノ コンゴウ リョウホウ デ チリョウ シタ コウGBM コウタイケイ キュウソク シンコウセイ シキュウタイジンエン ノ 1レイ

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Abstract

<p>Recently, the use of simple plasma exchange (sPE) with fresh frozen plasma to treat kidney disease has been replaced with selective plasma exchange (SePE) with albumin solution due to the efficacy, safety, and cost-effectiveness of the latter approach. SePE reduces the titer of the IgG anti-glomerular basement membrane (GBM) antibody, although it also partially removes some anticoagulant factors. Here, we report the case of a patient who was positive for the anti-GBM antibody, who we treated with a combination of sPE and SePE. The combination treatment reduced the patient’s anti-GBM antibody level to 10 U/mL, but did not affect his anticoagulant factor levels. As there have been few reports regarding combination treatment with sPE and SePE, we summarize the merits and demerits of this approach.</p>

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