Therapeutic Effect of Plasmapheresis in Relapsed Focal Segmental Glomerulosclerosis after Steroid Pulse Therapy

Kim, Lan; Kim, Eun-Mi

J Korean Soc Pediatr Nephrol > Volume 7(1); 2003 > Article

J Korean Soc Pediatr Nephrol 2003;7(1): 1-8.

스테로이드 충격요법 후 재발된 국소성 분절성 사구체 경화증에서 혈장반출법의 치료 효과

김란, 김은미

¹순천향대학교 의과대학 소아과학교실
²순천향대학교 의과대학 소아과학교실

Therapeutic Effect of Plasmapheresis in Relapsed Focal Segmental Glomerulosclerosis after Steroid Pulse Therapy

Lan Kim, Eun-Mi Kim

¹Department of Pediatrics, Soon Chun Hyang University College of Medicine
²Department of Pediatrics, Soon Chun Hyang University College of Medicine

ABSTRACT

Purpose : Focal segmental glomerulosclerosis(FSGS) is known to have a poor prognosis and a poor response to treatment. We performed a combination therapy of plasmapheresis, steroid pulse and immunoglobulin in 4 patients with relapsed steroid dependent(SD) or steroid resistant(SR) FSGS after steroid pulse therapy.
Materials and Methods : 8 cycles of plasmapheresis were performed in 4 patients with biopsy proven FSGS who had relapsed after steroid pulse therapy from March 1988 to July 2002. Clinical findings and treatment courses were reviewed retrospectively.
Results : Among the 4 patients, there were 3 males and 1 female. After 8 cycles of plasmapheresis, clinical remissions were obtained. Two of the four patients had two relapses and received 2 more cycles of plasmapheresis which resulted in remissions. One of these patients had two further relapses and was treated with oral steroid resulting in clinical remission. Three patients have maintained normal serum creatinine level and glomerular filtration rates during the follow-up period of 10 years, and the other 1 patient for 5 months.
Conclusion : A combination therapy of plasmapheresis, steroid pulse and immunoglobulin led to a complete remission in patients with FSGS who were SD or SR and was effective in maintaining normal renal function.

Key words: Plasmapheresis | Focal segmental glomerulosclerosis