Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence
A 26-year-old man highly suspected of having antiglomerular basement membrane (GBM) disease was treated with corticosteroid pulse therapy 9 days after initial infection-like symptoms with high procalcitonin value. The patient required hemodialysis the next day of the treatment due to oliguria. In ad...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2017/7143649 |
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| author | Yoshihide Fujigaki Chikayuki Morimoto Risa Iino Kei Taniguchi Yosuke Kawamorita Shinichiro Asakawa Daigo Toyoki Shinako Miyano Wataru Fujii Tatsuru Ota Shigeru Shibata Shunya Uchida |
| author_facet | Yoshihide Fujigaki Chikayuki Morimoto Risa Iino Kei Taniguchi Yosuke Kawamorita Shinichiro Asakawa Daigo Toyoki Shinako Miyano Wataru Fujii Tatsuru Ota Shigeru Shibata Shunya Uchida |
| author_sort | Yoshihide Fujigaki |
| collection | DOAJ |
| description | A 26-year-old man highly suspected of having antiglomerular basement membrane (GBM) disease was treated with corticosteroid pulse therapy 9 days after initial infection-like symptoms with high procalcitonin value. The patient required hemodialysis the next day of the treatment due to oliguria. In addition to corticosteroid therapy, plasmapheresis was introduced and the patient could discontinue hemodialysis 43 days after the treatment. Kidney biopsy after initiation of hemodialysis confirmed anti-GBM disease with 86.3% crescent formation. Physician should keep in mind that active anti-GBM disease shows even high procalcitonin value in the absence of infection. To pursue recovery of renal function, the challenge of the immediate and persistent treatment with high-dose corticosteroids plus plasmapheresis for highly suspected anti-GBM disease is vitally important despite the presence of reported predictors for dialysis-dependence including oliguria and requiring hemodialysis at presentation. |
| format | Article |
| id | doaj-art-08d4e85b1d5a4a02925742087e725ef6 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-08d4e85b1d5a4a02925742087e725ef62025-02-03T01:12:42ZengWileyCase Reports in Nephrology2090-66412090-665X2017-01-01201710.1155/2017/71436497143649Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-DependenceYoshihide Fujigaki0Chikayuki Morimoto1Risa Iino2Kei Taniguchi3Yosuke Kawamorita4Shinichiro Asakawa5Daigo Toyoki6Shinako Miyano7Wataru Fujii8Tatsuru Ota9Shigeru Shibata10Shunya Uchida11Department of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, JapanA 26-year-old man highly suspected of having antiglomerular basement membrane (GBM) disease was treated with corticosteroid pulse therapy 9 days after initial infection-like symptoms with high procalcitonin value. The patient required hemodialysis the next day of the treatment due to oliguria. In addition to corticosteroid therapy, plasmapheresis was introduced and the patient could discontinue hemodialysis 43 days after the treatment. Kidney biopsy after initiation of hemodialysis confirmed anti-GBM disease with 86.3% crescent formation. Physician should keep in mind that active anti-GBM disease shows even high procalcitonin value in the absence of infection. To pursue recovery of renal function, the challenge of the immediate and persistent treatment with high-dose corticosteroids plus plasmapheresis for highly suspected anti-GBM disease is vitally important despite the presence of reported predictors for dialysis-dependence including oliguria and requiring hemodialysis at presentation.http://dx.doi.org/10.1155/2017/7143649 |
| spellingShingle | Yoshihide Fujigaki Chikayuki Morimoto Risa Iino Kei Taniguchi Yosuke Kawamorita Shinichiro Asakawa Daigo Toyoki Shinako Miyano Wataru Fujii Tatsuru Ota Shigeru Shibata Shunya Uchida Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence Case Reports in Nephrology |
| title | Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence |
| title_full | Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence |
| title_fullStr | Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence |
| title_full_unstemmed | Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence |
| title_short | Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence |
| title_sort | discontinuation of hemodialysis in a patient with anti gbm disease by the treatment with corticosteroids and plasmapheresis despite several predictors for dialysis dependence |
| url | http://dx.doi.org/10.1155/2017/7143649 |
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