Childhood Kidney Diseases
- Volume 9 Issue 1
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- Pages.38-45
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- 2005
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- 2384-0242(pISSN)
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- 2384-0250(eISSN)
An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients
소아에서 시행한 치료적 혈장교환술 9례의 임상적 고찰
- Lee Jee-Hyun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
- Jeon Ga-Won (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
- Park Sung-Eun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
- Jin Dong-Kyu (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
- Paik Kyung-Hoon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
- 이지현 (성균관대학교 의과대학 소아과학교실) ;
- 전가원 (성균관대학교 의과대학 소아과학교실) ;
- 박성은 (성균관대학교 의과대학 소아과학교실) ;
- 진동규 (성균관대학교 의과대학 소아과학교실) ;
- 백경훈 (성균관대학교 의과대학 소아과학교실)
- Published : 2005.04.01
Abstract
Purpose : The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. Methods : Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number an[;. method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. Results : The patients' ages ranged from 26 mont]Is to 16 years of age, and the mean age was 9.9 years. There were S males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic svndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly Progressive glomerulonephritis(RPGN), 1 case of focal segmental glomorulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemoIThage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. Conclusion : Although it is presumptuous to generalize the therapeutic effects of plasma pheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.
목 적 : 본 연구에서는 소아의 다양한 질환에서 시행한 치료적 혈장 교환술 9례의 치료 경과를 분석하고자 하였다. 방 법 : 원심 분리 기기를 이용한 COBE Spectra 기기를 이용하여 치료적 혈장 교환술을 시행하였으며 시행한 증례별로 원인 질환, 시행 횟수, 시행 방법, 치료 경과, 예후 등을 병록 기록지를 통하여 후향적으로 분석하였다. 결 과 : 대상 환아 9명의 연령 분포는 2세에서 16세로 평균 연령은 9.8세였으며 성비는 남아 5명, 여아 4명이었다. 치료적 혈장 교환술을 시행하게된 원인 질환은 용혈성 요독 증후군 2례, 루프스 신염 1례, 급속 진행성 신염 2례, 국소성 분절성 사구체 경화증 1례, 폐출혈로 발현한 전신성 혈관염 1례, 폐출혈을 동반한 원인 미상의 급성 신부전 1례, 신이식후 급성 거부 반응 1례였다. 혈장 교환 시행 횟수는 3회에서 13회로 평균6.9