title: Low-density lipoprotein apheresis for proteinuria in lupus nephritis with intraglomerular foam cells containing cholesterol crystals.
abstract: A 28-year-old woman with systemic lupus erythematosus was referred to our hospital due to nephrotic-level proteinuria despite approximately 1 year of treatment with 50 to 60 mg/d of prednisolone and 100 to 150 mg/d of cyclosporine with methylprednisolone pulse therapy. Kidney biopsy showed diffuse global lupus nephritis (World Health Organization class 4-G A/C) with many intraglomerular foam cells containing cholesterol crystals. Surprisingly, proteinuria diminished after only 5 low-density lipoprotein (LDL) cholesterol apheresis sessions. This case demonstrated the potential of LDL apheresis to exhibit a remarkable effect on not only focal segmental glomerulosclerosis, but also other types of nephritis, particularly nephritis with intraglomerular foam cells.
authors.affiliation: Sakurajyuji Hospital, Kumamoto, Japan. Electronic address: n.shiraishi@sakurajyuji.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shiraishi
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hayata
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tajiri-Okamura
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Nakayama
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Kohda
authors.affiliation: Tomei Atsugi Hospital, Kanagawa, Japan.
authors.forename: Kimio
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Department of Nephrology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mukoyama
mesh_terms: D000328:Adult; D001781:Blood Component Removal; D002784:Cholesterol / Q000032:analysis*; D003460:Crystallization; D005260:Female; D005487:Foam Cells / Q000737:chemistry* / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000737:chemistry / Q000473:pathology; D008077:Lipoproteins, LDL / Q000008:administration & dosage*; D008181:Lupus Nephritis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011507:Proteinuria / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
chemical_list: D008077:Lipoproteins, LDL; D002784:Cholesterol
keywords: LDL cholesterol; Low-density lipoprotein (LDL) apheresis; cholesterol crystal; foam cell; lupus nephritis; nephrotic syndrome; proteinuria; systemic lupus erythematosus (SLE)