Liu Caihong, Li Xu, Yang Yingying, Zhao Yuliang, Zhang Ling
Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China.
Department of Nephrology, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
Heliyon. 2024 Jul 23;10(15):e35049. doi: 10.1016/j.heliyon.2024.e35049. eCollection 2024 Aug 15.
Anti-glomerular basement membrane (GBM) nephritis is a rare autoimmune disorder characterized by acute and rapidly progressive glomerulonephritis. In this report, we present the case of a 52-year-old woman with anti-GBM nephritis who was treated with Staphylococcus Protein A immunoadsorption in combination with glucocorticoids and cyclophosphamide. After 8 cycles of immunoadsorption, the patient's anti-GBM antibodies decreased from 363 AU/mL to less than 20 AU/mL, accompanied by a dropped immunoglobin G level, although renal impairment persisted. We reviewed the therapeutic options for anti-GBM nephritis and compared plasma exchange, double filtration plasmapheresis, and immunoadsorption with regard to plasma consumption, allergic events, and plasma components loss. Protein A immunoadsorption appears to be a promising treatment modality for anti-GBM nephritis.
抗肾小球基底膜(GBM)肾炎是一种罕见的自身免疫性疾病,其特征为急性和快速进展性肾小球肾炎。在本报告中,我们介绍了一例52岁患有抗GBM肾炎的女性患者,该患者接受了葡萄球菌蛋白A免疫吸附联合糖皮质激素和环磷酰胺治疗。经过8个周期的免疫吸附治疗后,患者的抗GBM抗体从363 AU/mL降至低于20 AU/mL,同时免疫球蛋白G水平下降,尽管肾功能损害仍然存在。我们回顾了抗GBM肾炎的治疗选择,并比较了血浆置换、双重滤过血浆置换和免疫吸附在血浆消耗、过敏事件和血浆成分丢失方面的情况。蛋白A免疫吸附似乎是抗GBM肾炎一种有前景的治疗方式。