| 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 | |
|---|---|---|
| 題名 | Henoch-Schonlein紫斑病 | |
| 発刊年月 | 2001年 03月 | |
| 著者 | 小板橋 靖 | 聖マリアンナ医科大学小児科 |
| 著者 | 斉藤 陽 | 聖マリアンナ医科大学小児科 |
| 【 要旨 】 | 紫斑病性腎炎(PN)における血液浄化療法に伴う諸問題を文献的に検討した．急性期においては，急速進行性腎炎(RPGN)における血漿交換療法(PE)の成績を分析した．慢性期においては，合併症として中心網膜静脈閉塞症と，透析維持療法からの透析離脱症例を検討した．さらに，PNに対する腎移植症例を分析し，紫斑の再発，PNの臨床的・組織学的再発，移植腎の腎不全への進展について検討した．以上の結果，RPGNを伴うPNに対しては，PEやステロイド薬と免疫抑制薬による積極的治療導入の意義と，慢性期においても，たとえ腎移植後であっても，腎のみならず全身諸臓器における血管炎の再発に対して注意を払う必要性を強調したい． | |
| Theme | Management of Systemic Diseases with Blood Purification : Aute and Chronic Stage of Diseases | |
|---|---|---|
| Title | Henoch-Schonlein purpura | |
| Author | Yasushi Koitabashi | Department of Pediatrics, St. Marianna University School of Medicine |
| Author | Akira Saito | Department of Pediatrics, St. Marianna University School of Medicine |
| [ Summary ] | Literatures on some recent topics concerning dialysis and renal transplantation for purpura nephritis (PN) cases were investigated. 1. The effect of plasmapheresis (PP) on long-term outcome has been confirmed in cases showing rapidly progressive glomerulonephritis (RPGN) of PN. 2. The PN case in where central retinal vein occlusion occurred abruptly during maintenance hemodialysis, following impaired vision of the left eye, and another who recovered spontaneously from end stage renal failure after a six-month period, have been reported. 3. It has been indicated that such events as the recurrence of purpura, clinical and histological occurrence of PN and progression into renal failure, occurred in PN cases after renal transplantation. From these reports, we would emphasize the significance of PP in PN cases with RPGN and the necessity to pay close attention to cases where vasculitis may recur in the other organs, as well as the kidnies, in PN cases after renal transplantation. |
|