Subject(s)
Kidney Diseases/etiology , Vasculitis/etiology , Diagnosis, Differential , Glomerulosclerosis, Focal Segmental/etiology , Glomerulosclerosis, Focal Segmental/pathology , Glomerulosclerosis, Focal Segmental/therapy , Humans , Kidney Diseases/pathology , Kidney Diseases/therapy , Kidney Function Tests , Kidney Glomerulus/blood supply , Muscle, Smooth, Vascular/pathology , Vasculitis/pathology , Vasculitis/therapyABSTRACT
Autoantibodies against neutrophil cytoplasmic antigens (ANCA) are found in patients with different kinds of systemic vasculitis and glomerulonephritis, both characteristic manifestations of systemic lupus erythematosus (SLE). The present study was designed to clarify the nature of ANCA seen in SLE patients and their correlation with the clinical findings.
Subject(s)
Autoantibodies/blood , Immunoglobulin G/blood , Lupus Erythematosus, Systemic/immunology , Antibodies, Antineutrophil Cytoplasmic , Antibodies, Antinuclear/immunology , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique , Glomerulonephritis/complications , Glomerulonephritis/immunology , Humans , Lupus Erythematosus, Systemic/complications , Vasculitis/complications , Vasculitis/immunologyABSTRACT
Extracorporeal treatment of acute systemic lupus erythematous (SLE) by plasmapheresis has been reported for more than 10 years. Risks of plasmapheresis include unselective procedure, an immunoadsorbent plasma perfusion by IM-P column. Eight of 10 patients evaluated improved through 3 treatments of a 2-liter perfusion. Analysis of proteins removed during plasma perfusion showed a semiselectivity of the IM-P column for circulating immune complexes and anti-dsDNA antibodies. After perfusion of 2 liters of plasma, these substances were reduced by about 35-40%, whereas whole protein was lowered by less than 10% and immunoglobulins by about 18%. Our results in severe SLE indicate that immunoadsorption having the advantage of lowering side effects by dispensing wih foreign protein substitution.
