title: The Effects of Plasma Exchange on Severe Vasculitis with Diffuse Alveolar Hemorrhage.
abstract: Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is a life-threatening disease characterized by rapidly progressive glomerulonephritis (RPGN) and diffuse alveolar hemorrhage (DAH). Glucocorticoids and immunosuppressants are commonly used to treat this disease but may induce irreversible side effects, particularly in elderly patients. We herein report the case of a 76-year-old woman with RPGN. After methylprednisolone pulse therapy, DAH occurred, and she required ventilatory support. After plasma exchange, her serum creatinine level improved, and she was discharged with home oxygen therapy. Immunosuppressive agents other than glucocorticoids were not required. In conclusion, plasma exchange with glucocorticoid therapy may be effective in treating severe ANCA-associated vasculitis in elderly patients.
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Goto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakai
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishi
mesh_terms: D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology / Q000276:immunology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006470:Hemorrhage / Q000150:complications / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D010951:Plasma Exchange / Q000009:adverse effects; D010956:Plasmapheresis / Q000009:adverse effects; D016896:Treatment Outcome; D014657:Vasculitis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D005938:Glucocorticoids; D007166:Immunosuppressive Agents