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Am J Kidney Dis. 2003 Dec;42(6):1149-53.

Plasmapheresis therapy for diffuse alveolar hemorrhage in patients with small-vessel vasculitis.

Author information

1
Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill 27599-7155, USA. philip_klemmer@med.unc.edu

Abstract

BACKGROUND:

Unlike Goodpasture's syndrome with diffuse alveolar hemorrhage (DAH), there are few studies examining therapy for patients with DAH associated with antineutrophil cytoplasmic antibody (ANCA)-associated small-vessel vasculitis (SVV).

METHODS:

We performed a retrospective review of all such patients presenting to our institution between 1995 and 2001. All patients were treated with apheresis and induction immunosuppressive therapy; namely, intravenous methylprednisolone and/or intravenous cyclophosphamide.

RESULTS:

DAH resolved with apheresis in 20 of 20 patients (100%) with 6.4 (average) treatments. There were no complications of therapy. Half the patients (7 of 14) who also presented with azotemia were discharged with improved renal function.

CONCLUSION:

Patients with ANCA-related SVV and DAH benefit from prompt initiation of apheresis coupled with aggressive immunosuppressive therapy. Such therapy can be lifesaving with respect to the pulmonary component of this syndrome.

PMID:
14655185
[Indexed for MEDLINE]

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