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

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

• Kim L
• Kim EM

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.

Keyword

Plasmapheresis; Focal segmental glomerulosclerosis

MeSH Terms

Biopsy
Creatinine
Female
Follow-Up Studies
Glomerular Filtration Rate
Glomerulosclerosis, Focal Segmental*
Humans
Immunoglobulins
Male
Plasmapheresis*
Prognosis
Recurrence
Retrospective Studies
Creatinine
Immunoglobulins