title: A case report of successful long-term relapse control by protein-a immunoadsorption in an immunosuppressive-treated patient with end-stage renal disease due to Wegener's granulomatosis.
abstract: A long-term female hemodialysis patient with end-stage renal disease due to Wegener's granulomatosis (WG) experienced a severe relapse when immunosuppressive therapy was switched from prednisone and cyclophosphamide to azathioprine maintenance therapy. Ten courses of protein A immunoadsorption therapy and switching immunosuppressive therapy to mycophenolate mofetil have proved to be very successful and free of side effects. The patient has fully recovered from all clinical WG symptoms and is still in remission ten months after the treatment.
authors.affiliation: Center of Nephrology, Mettmann, Germany. Koch@dialysemettmann.de
authors.forename: Michael
authors.initials: M
authors.lastname: Koch
authors.forename: Matthias
authors.initials: M
authors.lastname: Kohnle
authors.forename: Rudolf
authors.initials: R
authors.lastname: Trapp
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007163:Immunosorbent Techniques; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction / Q000379:methods; D006435:Renal Dialysis; D013205:Staphylococcal Protein A
chemical_list: D007166:Immunosuppressive Agents; D013205:Staphylococcal Protein A; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D001379:Azathioprine; D011241:Prednisone