ANCA-Associated Vasculitis: Value of Apheresis in Initial Treatment
ANCA-Associated Vasculitis: Value of Apheresis in Initial Treatment作者机构：Amirou Boubacar Diallo National Hospital of Niamey Niamey Niger National Hospital of Zinder Zinder Niger Faculty of Health Sciences of Zinder Zinder Niger Nephrology Hemodialysis Apheresis and Kidney Transplantation Department Université Hospital Grenoble Grenoble France Université Grenoble Alpes Grenoble France
出 版 物：《Open Journal of Nephrology》 (肾脏病（英文）)
年 卷 期：2022年第12卷第2期
页 面：195-202页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：ANCA-Associated Vasculitis Apheresis Rituximab Remission Rapidly Progressive Glomerulonephritis
摘 要：Introduction: Vasculitis associated with anti-neutrophil cytoplasm antibodies (ANCA) can be grouped with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MAP), and eosinophilic granulomatosis with polyangiitis (EGPA). Diagnosis of these rare pathologies is based on clinical presentation, the positivity of ANCA, and, if possible, histological proof of vasculitis. Our study describes a series of six cases of ANCA-associated vasculitis where due to the severity of symptoms apheresis sessions were started from the beginning of the therapy. Patients and methods: We conducted a retrospective, single-center observational, monocentric study on all patients treated by apheresis for ANCA vasculitis in the period January 01, 2016 to December 01, 2019. Results: We identified six cases of ANCA vasculitis treated by apheresis over a 3-year period. The mean age was 61 ± 19 years;M/F gender ratio was 1:1. Initial renal damage in all patients was rapidly progressive glomerulonephritis. Inflammatory syndrome occurred in all patients with average CRP of 82 mg/L. All patients had positive ANCA at diagnosis. Four patients required renal replacement therapy at the time of diagnosis. The induction regimen consisted of rituximab associated with IV boluses of methylprednisolone. The apheresis techniques used were the same for all patients, i.e. plasmapheresis. Outcomes were favorable for five patients;only one patient became dependent on hemodialysis. No mortality occurred. Conclusion: This study analyzed practices for the management of patients with ANCA vasculitis. No patient was treated with cyclophosphamide as a first approach but rituximab instead. Plasmapheresis was given because of symptoms severity at initial diagnosis.
维普期刊数据库