Influence of immunoadsorption on the removal of immunoglobulin G autoantibodies in crescentic glomerulonephritis.
We report the treatment of 5 patients with crescentic glomerulonephritis by immunoadsorption using a protein A column. Two had systemic vasculitis, 2 antiglomerular basement membrane disease and 1 systemic lupus erythematosus (SLE). In the patients with systemic vasculitis and SLE, there was successful removal of autoantibodies and rapid control of disease; remission was maintained over a mean follow-up of 2 years. Clinical improvement was not seen in 2 patients with anti-glomerular basement membrane (GBM) disease who presented with dialysis-dependent renal failure. There were no apparent clinical side-effects related to the immunoadsorption procedure. Protein A immunoadsorption offers a semiselective alternative to plasma exchange and appears to be safe and efficient in removing pathogenic autoantibodies in crescentic glomerulonephritis without anti-GBM antibodies.
Esnault
V L
VL
Service de Néphrologie-Immunologie Clinique, CHU, Nantes, France.
Testa
A
A
Jayne
D R
DR
Soulillou
J P
JP
Guenel
J
J
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000276:immunology; D001323:Autoantibodies / Q000302:isolation & purification*; D005112:Extracorporeal Circulation; D005260:Female; D005921:Glomerulonephritis / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology / Q000302:isolation & purification*; D007163:Immunosorbent Techniques; D007674:Kidney Diseases / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D013205:Staphylococcal Protein A; D014657:Vasculitis / Q000276:immunology / Q000628:therapy
D000906:Antibodies; D001323:Autoantibodies; D007074:Immunoglobulin G; D013205:Staphylococcal Protein A; C051951:antiglomerular basement membrane antibody