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Abstract
We report the treatment of 5 patients with crescentic glomerulonephritis by immunoadsorption
using a protein A column. Two had systemic vasculitis, 2 antiglomerular basement membrane
disease and 1 systemic lupus erythematosus (SLE). In the patients with systemic vasculitis
and SLE, there was successful removal of autoantibodies and rapid control of disease;
remission was maintained over a mean follow-up of 2 years. Clinical improvement was
not seen in 2 patients with anti-glomerular basement membrane (GBM) disease who presented
with dialysis-dependent renal failure. There were no apparent clinical side-effects
related to the immunoadsorption procedure. Protein A immunoadsorption offers a semiselective
alternative to plasma exchange and appears to be safe and efficient in removing pathogenic
autoantibodies in crescentic glomerulonephritis without anti-GBM antibodies.