Plasmapheresis in Diffuse Alveolar Hemorrhage as Perinuclear Antineutrophil Cytoplasmic Antibody‐Associated Vasculitis Relapse on Hemodialysis

Cigarrán, Secundino; Castro, Elena; Pousa, Montserrat; Paredes, Sonia; Bernardo, Hugo; Porteiro, Montserrat

doi:10.1111/j.1744-9987.2010.00812.x

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Randomized trials on plasma exchange in the treatment of diffuse alveolar hemorrhage are unavailable. The retrospective studies and case reports suggest benefits of plasma exchange in diffuse alveolar hemorrhage (14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Plasma Exchange in Anti‐Neutrophil Cytoplasmic Antibody‐Associated Vasculitis

et al. 2019

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We aimed to investigate the efficacy of plasma exchange on severe anti‐neutrophil cytoplasmic antibody‐associated vasculitis (AAV). Of 182 patients with AAV in our hospital, 12 patients with life‐threatening organ damage (rapidly progressive glomerulonephritis and/or diffuse alveolar hemorrhage) underwent centrifuge‐based therapeutic plasma exchange and immunosuppressive therapy. Twenty‐four patients matched for age, serum creatinine, and severity of vasculitis, who received high‐dose glucocorticoids with or without immunosuppressants, were included in the nonplasma exchange group. Renal survival rate at 2 years from induction treatment was not significantly different between the plasma and nonplasma exchange groups (P = 0.524). Mortality rate at 5 years from induction treatment was not significantly different between the plasma and nonplasma exchange groups (P = 0.631). In this retrospective study, we could not show the significant differences in the renal survival rate and survival rate between the two groups.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Plasma Exchange in Anti‐Neutrophil Cytoplasmic Antibody‐Associated Vasculitis

et al. 2019

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“…'ları p-ANCA ilişkili vaskülite bağlı renal yetmezliği gelişen ve kronik hemodializ yapılan bir hastada gelişen DAH'de plazmaferez yaparak klinik tablonun düzeldiğini bildirmişlerdir (17).…”

Section: Discussionunclassified

ANCA Iliskili Vaskulite Bagli Gelisen Difuz Alveolar Hemorajide Plazmaferez Tedavisi: Olgu Sunumu ve Literaturun Gozden Gecirilmesi

2015

GMJ

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ÖZETDiffüz alveolar hemoraji (DAH), antinötrofil sitoplazmik antikor (ANCA) ilişkili vaskülitlerin en ciddi klinik durumlarından biridir. Burada perinükleer-ANCA ilişkili vaskülite bağlı akut renal yetmeliği ve DAH olan bir olgu sunulmuştur. Olgumuzda indüksiyon immünsupresif (kortikosteroid ve siklofosfamid) tedavilerine rağmen renal fonksiyonlarında bir düzelme olmamış ve DAH gelişmiştir. Kurtarma tedavisi olarak plazmaferez başlanmış ancak 5 seans sonrasında klinik tabloda düzelme olmadığı için kesilmiştir. Hasta takibinde muhtemel koroner tutuluma bağlı akut koroner sendrom nedeniyle kaybedilmiştir. Bu olgu ile birlikte progresif sistemik vasküliti olan olgularda plazmaferez tedavisinin kurtarıcı bir tedavi olarak kullanılabileceği; ancak sonuçların her zaman yüz güldürücü olmadığı sonucuna varılmıştır. ABSTRACTDiffuse alveolar hemorrhage (DAH) is one of the most serious involvement of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. We report a case of a perinuclear-ANCA associated vasculitis with acute renal failure and DAH. The patient received induction immunosuppressive therapy (corticosteroid and cyclophosphamide), but patient's renal function didn't improve and then DAH occured. Plasmapheresis was started as rescue therapy. The DAH didn't resolve at the end of five procedures. Patient died of acute coronary syndrome due to probable coronary vascular involvement.We concluded that plasmapheresis rescue therapy can't get benefit in such a progressive systemic ANCA-associated vasculitis.

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“…The "right time" means that the administration of MTP and cyclophosphamide should be started as early as possible; we suggest that therapy within 3 days of admission would be optimal timing. Although there has not been sufficient evidence to support the efficacy of plasmapheresis in patients with DAH, early plasmapheresis to remove pathogenic antibodies has been recognized as an effective and fast-acting adjuvant therapy in some studies [14][15][16].…”

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confidence: 99%

Clinical Features and Treatment Strategy of Vasculitis-Associated Diffuse Alveolar Hemorrhage

Tien

Chiu

Hung

et al. 2018

BJSTR

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Diffuse alveolar hemorrhage (DAH) is an acute, lifethreatening syndrome with clinical manifestations characterized by hemoptysis, dyspnea, reduced hemoglobin, and diffuse radiographic pulmonary infiltrations. The histopathology of DAH involves the accumulation of intra-alveolar red blood cells (RBCs) originating from the alveolar capillaries [1]. A broad spectrum of disorders, including immune-mediated diseases, infections, malignancies, and drugs, are all the possible underlying etiologies of DAH. The most common clinical causes of DAH include small vessel vasculitis, known as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), followed by Goodpasture syndrome and other collagen vascular diseases [1,2].Vasculitis-associated DAH typically presents with acute/ fulminant course and generally demonstrates high morbidity and substantial mortality [3,4]. Therefore, prompt diagnosis and aggressive treatment are required to improve survival. Recognition of vasculitis-associated DAH depends on the awareness of clinicians; once the diagnosis is established, the underlying etiology must be investigated to initiate proper management. Delayed diagnosis and insufficient treatment for the early stages of vasculitis-related

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Plasmapheresis in Diffuse Alveolar Hemorrhage as Perinuclear Antineutrophil Cytoplasmic Antibody‐Associated Vasculitis Relapse on Hemodialysis

Cited by 7 publications

References 22 publications

Efficacy of Plasma Exchange in Anti‐Neutrophil Cytoplasmic Antibody‐Associated Vasculitis

Efficacy of Plasma Exchange in Anti‐Neutrophil Cytoplasmic Antibody‐Associated Vasculitis

ANCA Iliskili Vaskulite Bagli Gelisen Difuz Alveolar Hemorajide Plazmaferez Tedavisi: Olgu Sunumu ve Literaturun Gozden Gecirilmesi

Clinical Features and Treatment Strategy of Vasculitis-Associated Diffuse Alveolar Hemorrhage

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