An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients

Lee, Jee-Hyun; Jeon, Ga-Won; Park, Sung-Eun; Jin, Dong-Kyu; Paik, Kyung-Hoon

J Korean Soc Pediatr Nephrol > Volume 9(1); 2005 > Article

J Korean Soc Pediatr Nephrol 2005;9(1): 38-45.

소아에서 시행한 치료적 혈장교환술 9례의 임상적 고찰

이지현, 전가원, 박성은, 진동규, 백경훈

¹성균관대학교 의과대학 소아과학교실
²성균관대학교 의과대학 소아과학교실
³성균관대학교 의과대학 소아과학교실
⁴성균관대학교 의과대학 소아과학교실
⁵성균관대학교 의과대학 소아과학교실

An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients

Jee-Hyun Lee, Ga-Won Jeon, Sung-Eun Park, Dong-Kyu Jin, Kyung-Hoon Paik

¹Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine
²Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine
³Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine
⁴Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine
⁵Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine

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.

Key words: Plasmapheresis | Renal failure | Children