INFECTIVE ENDOCARDITIS-INDUCED CRESCENTIC GLOMERULONEPHRITIS DRAMATICALLY IMPROVED BY PLASMAPHERESIS

A 50-year-old woman was referred to our hospital because of skin purpu ra, anemia, high fever, and acute renal insufficiency. Five years ago, she had been diagnosed as having ventricular septal defect without an y complications. A blood culture drawn during the hospitalization grew Streptococcus viridans. She was diagnosed as having infective endocar ditis-induced crescentic glomerulonephritis (GN) according to echocard iography and renal biopsy results. Although antibiotic treatment alone showed no apparent efficacy, after the initiation of plasmapheresis, the high fever and acute renal insufficiency were dramatically improve d. After clinical stability was achieved, closure of the ventricular s eptal defect was performed. This result suggests that plasmapheresis m ay be beneficial in the treatment of infective endocarditis-induced cr escentic GN. The possible mechanisms of this therapy are discussed. (C ) 1998 by the National Kidney Foundation, Inc.