INFLUENCE OF IMMUNOADSORPTION ON THE REMOVAL OF IMMUNOGLOBULIN-G AUTOANTIBODIES IN CRESCENTIC GLOMERULONEPHRITIS

We report the treatment of 5 patients with crescentic glomerulonephrit is by immunoadsorption using a protein A column. Two had systemic vasc ulitis, 2 antiglomerular basement membrane disease and 1 systemic lupu s erythematosus (SLE). In the patients with systemic vasculitis and SL E, there was successful removal of autoantibodies and rapid control of disease; remission was maintained over a mean follow-up of 2 years. C linical improvement was not seen in 2 patients with anti-glomerular ba sement membrane (GBM) disease who presented with dialysis-dependent re nal failure. There were no apparent clinical side-effects related to t he immunoadsorption procedure. Protein A immunoadsorption offers a sem iselective alternative to plasma exchange and appears to be safe and e fficient in removing pathogenic autoantibodies in crescentic glomerulo nephritis without anti-GBM antibodies.