Document Detail


Treatment with cytapheresis for antineutrophil cytoplasmic antibody-associated renal vasculitis and its effect on anti-inflammatory factors.
MedLine Citation:
PMID:  16076370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the efficacy of cytapheresis for the treatment of rapidly progressive glomerulonephritis (RPGN) caused by myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis, the renal prognosis and the mortality rate at 1 year after treatment were compared between a Cytapheresis Group and a Steroid Pulse Group. The Cytapheresis Group included 10 patients who were treated with cytapheresis and oral corticosteroids. Five had granulocytapheresis with the Adacolumn (Japan Immuno Research Laboratories Co. Ltd, Takasaki, Japan) and the remaining five had leukocytapheresis with the leukocyte removal filter, Cellsorba (Asahi Medical Co. Ltd, Tokyo, Japan). The Steroid Pulse Group was comprised of 12 patients who were treated with methylprednisolone pulse therapy and oral corticosteroids. In the Cytapheresis Group, renal function recovered in 70% of the patients and the mortality rate was 10%. In the Steroid Pulse Group, renal function recovered in 66.7% and the mortality rate was 33.3%, with infection as the cause of death. Total doses of corticosteroids converted to prednisolone dose during a 1 month period, ranged from 280 mg to 1226 mg in the Cytapheresis Group. On the other hand, these dosages ranged from 2375 mg to 8380 mg in the Steroid Pulse Group. These results indicated that the mortality rate by infection could be reduced by adding cytapheresis therapy. Concerning the mechanism of cytapheresis, anti-inflammatory factors such as soluble tumor necrosis factor receptor, and interleukin-10 reduced after cytapheresis. These changes might be responsible for the efficacy of cytapheresis. In conclusion, cytapheresis is thought to be one of the effective treatments for RPGN caused by MPO-ANCA-associated vasculitis, reducing the levels of anti-inflammatory factors.
Authors:
Midori Hasegawa; Asako Watanabe; Hiroki Takahashi; Kazuo Takahashi; Masami Kasugai; Nahoko Kawamura; Hiroko Kushimoto; Kazutaka Murakami; Makoto Tomita; Kunihiro Nabeshima; Atsushi Oohashi; Fumiko Kondou; Hisaji Ooshima; Yoshiyuki Hiki; Satoshi Sugiyama
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  9     ISSN:  1744-9979     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-03     Completed Date:  2005-12-13     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  297-302     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan. mhase@fujita-hu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Aged
Antibodies, Antineutrophil Cytoplasmic / blood*
Combined Modality Therapy
Cytapheresis / methods*
Female
Glomerulonephritis / therapy*
Humans
Interleukin-1 / blood
Interleukin-10 / blood
Kidney / blood supply
Male
Methylprednisolone / therapeutic use
Middle Aged
Statistics, Nonparametric
Treatment Outcome
Tumor Necrosis Factor-alpha / metabolism
Vasculitis / therapy*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antibodies, Antineutrophil Cytoplasmic; 0/Interleukin-1; 0/Tumor Necrosis Factor-alpha; 130068-27-8/Interleukin-10; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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