Collapsing Focal Segmental Glomerulosclerosis in a Patient with Systemic Lupus Erythematosus

Tariq, Hassan; Rafiq, Arsalan; Franchin, Giovanni

doi:10.1155/2014/732192

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…Outcome is usually poor, at least half of the patients become dialysis dependent despite rigorous treatment. 7 In this case report, the contribution of CytoSorb ® hemadsorption (CH) to a patient with immunosuppressive treatment due to CG, sepsis, and multi-organ failure is discussed.…”

Section: Introductionmentioning

confidence: 99%

Successful application of CytoSorb^® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

et al. 2019

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Objective: CytoSorb® hemadsorption is an adjunctive therapy in order to reduce elevated cytokine levels of interleukin-6, interleukin-1, and tumor necrosis factor alpha. Here we present a successful administration of CytoSorb® hemadsorption in an immunocompromised pediatric patient with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis. Data sources: Clinical observations of one patient. Study selection: Case report. Data extraction: Data sources are clinical observation during patient management and patient’s medical records if needed. The patient’s consent was obtained prior to the study. Data synthesis: A 17-year-old male with diarrhea was admitted to the hospital and was later found to have elevated creatinine levels and proteinuria. The renal biopsy was consistent with collapsing glomerulopathy and treatment with multi immunosuppressive agents including corticosteroids, mycophenolate mofetil, and rituximab coupled with several courses of hemodialysis and plasmapheresis were administered. During the hospital stay, Stenotrophomonas maltophilia bacteremia from the blood and the catheter cultures were identified. No clinical response was achieved, and patient developed severe sepsis despite antibiotics, intravenous immunoglobulin, and supportive management including albumin, platelet and erythrocyte concentrations, and fresh frozen plasma. CytoSorb® hemadsorption was then added to the ongoing treatment for three consecutive days. Subsequent to CytoSorb® hemadsorption, immediate laboratory and clinical response were observed. Conclusion: This is the successful clinical report of an immunocompromised teenager with collapsing nephropathy, sepsis, and multi-organ dysfunction syndrome treated with a combination of renal replacement therapy and CytoSorb® hemadsorption. The usage of CytoSorb® hemadsorption represents a novel approach to improve survival of the patients with multiple organ dysfunction and sepsis.

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Section: Introductionmentioning

confidence: 99%

Successful application of CytoSorb^® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

et al. 2019

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“…Complete remission is <10% and a partial remission rate is reported to be around 15%. [ 4 ] Our case demonstrates possible milder form of the same disease which responded to pulse methyl prednisolone and monthly cyclophosphamide therapy.…”

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confidence: 78%

“…[ 3 ] Patients with CG and LN usually present with severe renal failure, massive proteinuria and usually have a poor response to steroids and immunosuppressive therapy. [ 4 ] These patients carry a poor prognosis and majority of them end up on dialysis. [ 5 ] At present, there is no evidence-based treatment approach for CG with LN owing to the rarity of this disease.…”

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confidence: 99%

Collapsing focal segmental glomerulosclerosis in a patient with systemic lupus erythematosus

2016

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“…19 How nonlupus nephritis develops in patients with SLE and FSGS is poorly understood according to Tariq et al's case report. 20 They suggested that it may be pathogenetically related to SLE. To our knowledge, our patient is the first case of LO-SLE presenting with LP and FSGS.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of Late-Onset Systemic Lupus Erythematosus With Focal Segmental Glomerulosclerosis and Lichen Planus: A Case Report

Sargın

Gürer

2017

Arch Rheumatol

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Late-onset systemic lupus erythematosus (LO-SLE) is defined when SLE develops after the age of 50 years and occurs in 3 to 18% of SLE patients. This late onset age has a strong modifying effect on the clinical presentation, disease course, response to treatment, and prognosis of SLE. LO-SLE often has delayed diagnosis and less common occurrence of severe manifestations. Arnaud et al. 1 suggests that pulmonary involvement and serositis are more frequent in LO-SLE, whereas malar rash, photosensitivity, arthritis, and nephropathy occur less commonly.In this article, we report a male patient presenting with lichen planus (LP) and focal segmental glomerulosclerosis (FSGS) who was subsequently diagnosed with LO-SLE. Our literature scan did not reveal any report on FSGS and LP as an initial manifestation in LO-SLE. CASE REPORTA 57-year-old male patient presented with complaints of pain in both hands and skin lesions in the left ankle for the last one year (Figure 1). He described symmetric joint pain and morning stiffness for longer than one hour. He had a two-year history of arthralgia and of using topical steroid and nonsteroidal anti-inflammatory drugs. He did not have any history of cutaneous lesions, oral or nasal ulcers, alopecia, pleural effusion, neuropathy, psychosis, seizures or myelitis. He did not have previous laboratory analyses. He had no history of smoking or alcohol consumption, or hypertension. His general condition was moderate, oriented, and cooperated. His blood pressure was 160/80 mmHg, and heart rate and temperature were normal. Locomotor system ABSTRACT Lichen planus and lupus nephritis with late-onset systemic lupus erythematosus (LO-SLE) may occur concomitantly. However, coexistence of LO-SLE with focal segmental glomerulosclerosis and lichen planus has not been defined. In this article, we report a 57-year-old male patient presenting with lichen planus and focal segmental glomerulosclerosis who was subsequently diagnosed with LO-SLE. To the best of our knowledge, this is the first case of LO-SLE presenting with lichen planus and focal segmental glomerulosclerosis.

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Collapsing Focal Segmental Glomerulosclerosis in a Patient with Systemic Lupus Erythematosus

Cited by 7 publications

References 28 publications

Successful application of CytoSorb^® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

Successful application of CytoSorb^® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

Collapsing focal segmental glomerulosclerosis in a patient with systemic lupus erythematosus

Coexistence of Late-Onset Systemic Lupus Erythematosus With Focal Segmental Glomerulosclerosis and Lichen Planus: A Case Report

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Collapsing Focal Segmental Glomerulosclerosis in a Patient with Systemic Lupus Erythematosus

Cited by 7 publications

References 28 publications

Successful application of CytoSorb® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

Successful application of CytoSorb® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

Collapsing focal segmental glomerulosclerosis in a patient with systemic lupus erythematosus

Coexistence of Late-Onset Systemic Lupus Erythematosus With Focal Segmental Glomerulosclerosis and Lichen Planus: A Case Report

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Successful application of CytoSorb^® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis

Successful application of CytoSorb^® hemadsorption in an immunocompromised teenager with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis