Plasmapheresis in rapidly progressive glomerulonephritis
Smith, P.K.; d'Apice, J.F.
American Journal of Medicine 65(4): 564-566
1978
ISSN/ISBN: 0002-9343 PMID: 707515 Document Number: 132501
Since the Hammersmiths group's report in 1975 of the successful treatment of a patient with Goodpasture's syndrome by a combination of plasmapheresis and immunosuppression, there has been considerable interest in plasmapheresis as a method of treating patients with immunologic renal disease. In view of the prevailing cynicism, particularly in the USA, about the value of therapy in most types of idiopathic glomerulonephritis, it is not surprising that reports of experience with this therapy in glomerulonephritis have emanated mainly from 2 sources. The initial restriction of any new and potentially hazardous therapy to a limited number of centers will increase the likelihood of its efficacy being determined quickly. This is particularly likely to be the case with rarer diseases, such as Goodpasture's syndrome, provided all cases are referred to the regional centers, so that a large experience can be accumulated reasonably quickly. The rationale for plasmapheresis and clinical experience with Goodpasture's syndrome and immune complex mediated glomerulonephritis are discussed.