Plasma exchange in the successful treatment of drug-induced renal disease.
A 20-year-old girl with rheumatoid arthritis who has been treated with D-penicillamine for 7 months presented with fulminating Goodpasture's syndrome and a focal necrotising glomerulonephritis. A 35-year-old man who had been taking a low dose of phenytoin for epilepsy presented with nephrotic syndrome and a mesangiocapillary glomerulonephritis. CH50, C3 and C4 were low and a high level of immune complexes was detected. Both patients had severe lesions which were unlikely to recover on immunosuppression alone so were treated with intensive plasma exchange. 2 patients are described with serious drug-induced renal disease who recovered with intensive plasma exchange and immunosuppression.
D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000139:chemically induced / Q000628:therapy; D000936:Antigen-Antibody Complex / Q000032:analysis; D005260:Female; D005921:Glomerulonephritis / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000139:chemically induced* / Q000628:therapy; D010396:Penicillamine / Q000009:adverse effects*; D010672:Phenytoin / Q000009:adverse effects*; D010951:Plasma Exchange
D000936:Antigen-Antibody Complex; D010672:Phenytoin; D010396:Penicillamine