Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/37653
Title: Long-Term Therapeutic Plasma Exchange to Prevent End-Stage Kidney Disease in Adult Severe Resistant Henoch-Schonlein Purpura Nephritis
Authors: Hamilton, Patrick
Ogundare, Olumide
Raza, Ammar
Ponnusamy, Arvind
Gorton, Julie
Alachkar, Hana
Choudhury, Jamil
Barratt, Jonathan
Kalra, Philip A.
First Published: 2015
Publisher: Hindawi Publishing Corporation
Citation: Case Reports in Nephrology, 2015, Volume 2015, Article ID 269895
Abstract: A 27-year-old man presented with a palpable purpuric skin rash and joint and abdominal pain in April 2010. He had acute kidney injury and his creatinine quickly deteriorated to 687 μmol/L, with associated nephrotic range proteinuria. Kidney biopsy showed crescentic Henoch-Schonlein nephritis. He was treated with intravenous cyclophosphamide and prednisolone despite which his renal function deteriorated; he required haemodialysis for a short duration and seven sessions of therapeutic plasma exchange (TPE). Renal function improved, but after discharge from hospital he suffered 2 further relapses, each with AKI, in 4 months. Cyclophosphamide was not effective and therefore Rituximab was introduced. He initially had a partial response but his renal function deteriorated despite continued therapy. TPE was the only treatment that prevented rapid renal functional deterioration. A novel long-term treatment strategy involving regular TPE every one to two weeks was initiated. This helped to slow his progression to end-stage kidney disease over a 3-year period and to prolong the need for renal replacement therapy over this time.
DOI Link: 10.1155/2015/269895
ISSN: 2090-6641
eISSN: 2090-665X
Links: http://www.hindawi.com/journals/crin/2015/269895/
http://hdl.handle.net/2381/37653
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2015 Patrick Hamilton et al. This is an open access article distributed under the Creative Commons Attribution License License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Appears in Collections:Published Articles, Dept. of Infection, Immunity and Inflammation



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