31. RESULT OF PULSE CORTICOSTEROID AND PLASMAPHERESIS IN TREATMENT OF RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN THE ELDERLY: CASE REPORT
Main Article Content
Abstract
Rapidly progressive glomerulonephritis is a rare disease, especially in the elderly, that is a medical emergency in nephrology requiring prompt diagnosis and treatment to rescue the renal function.
Objectives: to evaluate the results of the therapy of pulse corticosteroids and plasmapheresis in a case.
Patients: male, 69 years old. The reason for admission was edema of the lower extremities. The initial diagnosis was nephrotic syndrome – acute kidney injury. Laboratory result confirmed the diagnosis of rapidly progressive glomerulonephritis. The patient was treated with pulse corticosteroids and plasmapheresis.
Method: case report
Results: Renal biopsy was performed to conclude the pauci-immune crescentic glomerulonephritis. The ANCA tests were negative. The kidney function was recovered rapidly after 3 times of plasma exchange and discharged from the hospital after completing 10 courses of plasmapheresis.
Conclusion: Prompt and aggressive treatment with pulse corticosteroids and plasmapheresis attained good results that rescued the patient and kidney function recovered completely.
Article Details
Keywords
Rapidly progressive glomerulonephritis, pauci-immune crescentic glomerulonephritis, pulse corticosteroids, plasmapheresis
References
[2] Moroni G, Ponticelli C. (2014). Rapidly progressive crescentic glomerulonephritis: Early treatment is a must. Autoimmun Rev. 2014 Jul;13(7), pp 723-9.
[3] Oudah N, Al Duhailib Z, Alsaad K, et al. (2012). “Glomerulonephritis with crescents among adult saudi patients outcome and its predictors,” Clinical and Experimental Medicine. 12(2), pp 121–125.
[4] Chen, Tang Z, Xiang H, et al. (2016). “Etiology and outcome of crescentic glomerulonephritis from a single center in China: a10-year review,”American Journal of Kidney Diseases. 67(3), pp 376–383.
[5] Glassock RJ, Adler SG, Ward HJ, et al. (1991) “Primary glomerular diseases,”. In: Brenner B. M, Rector F. C (Eds). The Kidney 4th ed, pp 1182–1279, Saunders, Philadelphia, Pa, USA.
[6] Seo P, Stone JH. (2004). “The antineutrophil cytoplasmic antibody-associated vasculitides,”The American Journal of Medicine. 117(1), pp 39–50.
[7] Jennette JC. (2012). Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 65(1), pp 1-11.
[8] Jennette JC. (2011). Renal and systemic vasculitis. In: Floege J, Johnson RJ, Feehally J editors. Comprehensive Clinical Nephrology 4th ed. Elsevier Saunder.
[9] Jennette JC. (2003). Rapidly progressive crescentic glomerulonephritis. Kidney Int, 63(3), pp 1164-1177.
[10] Rampelli SK, Rajesh NG, Srinivas BH, et al (2016). Clinical spectrum and outcomes of crescentic glomerulonephritis: A single center experience. Indian J Nephrol, 26(4), pp 252-256.
[11] Trần Thị Bích Hương, Nguyễn Ngọc Lan Anh, Trần Văn Vũ et al. (2021). Chẩn đoán nguyên nhân của 123 bệnh nhân suy thận cấp tiến triển nhanh tại bệnh viện Chợ Rẫy. Y Học TP. Hồ Chí Minh. 25(2). pp 55-62.
[12] Lê PhạmThu Hà, Huỳnh Thoại Loan. (2014). Viêm cầu thận cấp tiến triển nhanh tại bệnh viện Nhi Đồng 1. Y Học TP. Hồ Chí Minh Trang. 18(4). pp 171-178.