特集名 | 全身性疾患における血液浄化療法 -- 急性期、および慢性期の対応 | |
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題名 | 皮膚疾患(天疱瘡など) | |
発刊年月 | 2001年 03月 | |
著者 | 瀧本 玲子 | 順天堂大学医学部附属順天堂浦安病院皮膚科学教室 |
著者 | 高森 建二 | 順天堂大学医学部附属順天堂浦安病院皮膚科学教室 |
【 要旨 】 | 皮膚科領域における血液浄化療法は,血漿交換療法に始まり,膜濾過法,免疫吸着法と発展してきたが,今日,主として用いられているのは二重濾過法(DFPP)である.対象疾患は天疱瘡,水疱性類天疱瘡,後天性表皮水疱症などの自己免疫性水疱症,皮膚筋炎,エリテマトーデスなどの膠原病,重症薬疹である中毒性表皮壊死症などで,いずれもきわめて良好な結果が得られており,これらの疾患においては標準的な治療法のーつとして確立されている.とくに,従来の治療法に抵抗する症例,従来の治療により副作用の出現した症例,合併症のため既存の治療法が使用できない症例に対しては第一選択の治療法として用いられている. |
Theme | Management of Systemic Diseases with Blood Purification : Aute and Chronic Stage of Diseases | |
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Title | Plasmapheresis for skin diseases (pemphigus etc.) | |
Author | Reiko Takimoto | Department of Dermatology, School of Medicine, Juntendo University Urayasu Hospital |
Author | Kenji Takamori | Department of Dermatology, School of Medicine, Juntendo University Urayasu Hospital |
[ Summary ] | Blood purification is presently being utilized quite succesfully in the treatment of autoimmune bullous diseases such as pemphigus, bullus pemphigoid and epidermolysis bullosa aquisita, some collagen diseases such as systemic erythematoses and dermatomyositis, and also in the case of severe drug eruption. In particular, apheresis therapy has been found to be useful for patients who has been unresponsive to conventional therapy and for whom conventional drugs were contraindicated due to complications. Within the field of dermatology, blood purification has been performed using three techniques: either plasma exchange, membrane filtration or immune adsorption. Recently, however, a double filtration method (DFPP), one of the membrane filtration techniques, has been utilized more frequently than the other methods because of its possible clinical advantages. In this paper the usefulness of apheresis and the most effective method of DFPP in the treatment of pemphigus are reported. |