Blood Plasma Exchange in Treatment of Lupus Nephritis

Systemic Lupus Erythematosus (SLE) is an autoimmune disease wherein the immune system mistakingly produces auto-antibodies that target at multiple body systems, including the kidneys. The patients have antibodies that target at its own nucleus, cytoplasm and cellular membranous antigens. Clinically, the patients are manifested as fever, facial erythema multiforme rash, photosensitivity, multiple oral ulcers, arthritis, serositis, vasculitis, Nephritis, central nerve system symptoms, etc. Extent of kidney damage is closely linked to the prognosis in SLE. Currently, blood plasma exchange is increasingly recognized as an effective technique in stopping autoimmune attack and controlling progression of the disease.

Lupus Nephritis has been acknowledged as an auto-immune mediated kidney disease. The patients have elevated levels of globulin, gamma globulin, IgG globulin, anti-DNA globulin, etc. Anto-antibodies that have been detected include anti-SM antibody, anti-RNP, anti-nucleoprotein, cystoplasm, anti-La, etc. Antigen-antibody immune complex on kidney tissues activate inflammations and damage healthy functioning kidney cells. Blood plasma exchange can rid the part of plasma that contains immune complex, and supplement fresh plasma to the patient. The treatment can rid circulatory immune complex and antibodies in bloodstream. Before the treatment the patients are detected high levels of circulatory immune complex; after the treatment, immune complex levels are obviously reduced and short-term treatment effect is obvious.

In a survey, seven women patients with SLE accepted blood plasma exchange treatment. After the treatment, the patients all have improvements to various extents. Three cases with acute renal failure have their urine output increased, kidney function recovered normal and SLE well controlled. The illness condition is controlled by plasma exchange in a patient with combined lung infection. In the other three cases, nerve symptoms disappeared and muscle cramps remitted. Five patients have immunoglobulin levels reduced to various degrees after blood plasma exchange. This provides proof for the efficacy of blood plasma exchange in treatment of SLE and lupus Nephritis.