Granulocyte and Monocyte Adsorption Apheresis in a Patient with Antiglomerular Basement Membrane Glomerulonephritis and Active Ulcerative Colitis
作者:
Tsukasa Nakamura,
Yukiko Suzuki,
Hikaru Koide,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 2003)
卷期:
Volume 325,
issue 5
页码: 296-298
ISSN:0002-9629
年代: 2003
出版商: OVID
关键词: Adacolumn;Antiglomerular basement membrane;Goodpasture syndrome;Granulocyte;Monocyte;Ulcerative colitis
数据来源: OVID
摘要:
A 58-year-old woman with Goodpasture syndrome and active ulcerative colitis is described. On admission, the patient had exertional dyspnea, hemoptysis, severe hypertension, and peripheral edema. Her serum levels of urea nitrogen and creatinine were increased, and her hemoglobin concentration was reduced. The patient had a rapidly progressive glomerulonephritis with acute renal failure. She was treated with methylprednisolone, cyclophosphamide, and plasmapheresis but failed to regain renal function. Circulating anti-glomerular basement membrane (anti-GBM) antibody was positive; however, serum antinuclear antibody, proteinase-3-antineutrophil cytoplasm antibody and myeloperoxidase-antineutrophil cytoplasm antibody were negative. Nineteen months after initial presentation, she developed abdominal pain and severe diarrhea. These symptoms did not improve with conventional treatment. Colonoscopy performed after 3 months showed multiple ulcers in the colon. She was diagnosed with ulcerative colitis. She underwent granulocyte and monocyte adsorption apheresis once per week for 5 weeks. At 8 weeks, her symptoms had improved; her stool number was markedly decreased, and the bloody stools and abdominal pain disappeared. These results suggest that granulocyte and monocyte apheresis may be of benefit in the therapy of a patient with ulcerative colitis who previously had Goodpasture syndrome
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