ループス腎炎のアフェレシス

概要

論文の詳細を見る
Sixteen patients with lupus nephritis, biopsy-proven WHO classification type-IV, were treated by a combination therapy of double-filtration plasmapheresis (DFPP) and steroids. All were nephrotic, non-steroid and in the acute stage at the beginning of therapy. The combination consisted of DFPP followed by steroid pulse within a week. This was repeated for 3 consecutive weeks. The efficacy of the therapy was evaluated at the point of 3, 6, 12, 24, 36 and 60 months. Rapid improvement was obtained in 7 out of the 16 patients. Three of the 7 patients were in complete remission (CR) of lupus nephritis at 3 months after the therapy. Similarly, CR was reported for 10 of the 16 patients at 12 months. None were nephrotic. At 60 months. 10 patients were in CR and 2 were on hemodialysis. Since circulating immune complexes as well as antibodies to DNA are effectively removed by DFPP, the combination is of clinical use in terms of remission induction of lupus nephritis. Repeated kidney biopsy showed marked improvement of end/extracapillary cell proliferation. The efficacy of DFPP itself was unable to be segregated from the beneficial effects in terms of clinical and histological improvements obtained by high doses of corticosteroid.
日本アフェレシス学会の論文
1998-05-31