An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients.
- Author:
Jee Hyun LEE
1
;
Ga Won JEON
;
Sung Eun PARK
;
Dong Kyu JIN
;
Kyung Hoon PAIK
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drwhite@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Plasmapheresis;
Renal failure;
Children
- MeSH:
Acute Kidney Injury;
Antibodies, Antineutrophil Cytoplasmic;
Centrifugation;
Child;
Female;
Hemorrhage;
Humans;
Hypocalcemia;
Kidney Transplantation;
Lupus Nephritis;
Male;
Pediatrics;
Plasma Exchange*;
Plasma*;
Plasmapheresis;
Prognosis;
Renal Insufficiency;
Retrospective Studies;
Systemic Vasculitis;
Vital Signs
- From:Journal of the Korean Society of Pediatric Nephrology
2005;9(1):38-45
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. METHODS: Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number and method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. RESULTS: The patients' ages ranged from 26 months to 16 years of age, and the mean age was 9.9 years. There were 5 males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic syndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly progressive glomerulonephritis(RPGN), 1 case of focal segmental glomerulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemorrhage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. CONCLUSION: Although it is presumptuous to generalize the therapeutic effects of plasmapheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.
