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Vasculitis induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Michiel De Vries, Marjolein Drent, Jan-Wil Cohen Tervaert
This potentially life-threatening syndrome of diffuse alveolar haemorrhage (DAH) and glomerulonephritis is usually called Goodpasture’s syndrome. The incidence is 1 per million. The syndrome affects two different age groups: persons in their mid 30s and in their late 50s.53 This pneumo-renal syndrome (PRS) is due to pulmonary capillaritis in conjunction with rapidly progressive glomerulonephritis. Renal biopsy displays extracapillary proliferating glomerulonephritis and renal immunohistology facilitates detection of the underlying disease. A pneumo-renal syndrome has been reported to occur in ANCA-associated vasculites (MPO/PR3-ANCA), including WG, CSS and MPA, in patients with antibodies against glomerular and alveolar basement membranes (i.e. anti-GBM or Goodpasture’s disease), systemic lupus erythematosus, and in infection-associated or drug-induced glomerulonephritis. Antiglomerular basement membrane (anti-GBM) antibodies attack the NC1 domain of the a3 chain of type IV collagen located in the basement membranes of the kidneys and alveoli. ANCA-associated vasculitides account for about 60 per cent of the cases, anti-GBM disease syndrome for about 20 per cent.54 There has been a tendency to believe that pulmonary disease takes a more aggressive course in PR3-positive ANCA patients,55 although others did not confirm that.56
Current Trends in Membrane Science
Published in Mihir Kumar Purkait, Randeep Singh, Membrane Technology in Separation Science, 2018
Mihir Kumar Purkait, Randeep Singh
The early attempts of plasmapheresis with membranes were not very successful due to the problem of fouling. Measures were taken to avoid fouling in the process by using stirrers, but stirrers faced the problems of the hemolysis of the red blood cells and low flux. Later, attempts were made to make the membranes of antifouling nature by using novel membrane materials. This antifouling membrane strategy has seen some success, but there were other areas requiring improvements, such as the optimization of transmembrane pressure and determination of the best pore geometry for the process. Hemolysis of red blood cells was still a major problem associated with the membrane plasmapheresis. Red blood cells at a pressure higher than the critical pressure hemolyze as well as through distortion in the pores. Therefore, these areas still require a lot of improvements and developments. Nowadays, plasmapheresis is not only used for the separation of plasma from blood but also therapeutically, for example, in plasma exchange therapy. In plasma exchange therapy, a patient’s plasma is purified by removing the toxic metabolites or compounds from it and then returning the purified plasma to the patient’s body. In general, this therapy is required in the cases of autoimmune diseases, such as Goodpasture syndrome, rheumatoid arthritis, autoimmune hemolytic anemia, and systemic lupus erythematosus, where an antibody or a component of self-immune system attacks one’s own body. For example, in Goodpasture syndrome an antibody attacks the basement membrane of lungs and kidneys, which results in bleeding and ultimately in respective organ failure. It is also successfully used for many other metabolic and immunological diseases/disorders. The technique of plasmapheresis in many cases is also used to detoxify the body of a patient in case of drug overdose or poison. This technique is also used by many pharmaceutical companies for animal blood pooling on a very large scale for yielding desired components/products from the collected blood, such as antibodies. Therefore, this technique also has a great future and will further develop with the developments in the field of membrane science.
A comprehensive summary of disease variants implicated in metal allergy
Published in Journal of Toxicology and Environmental Health, Part B, 2022
In addition to PAP, inhalation exposure to allergenic metals was also proposed to play a role in some cases of Goodpasture’s syndrome. Goodpasture’s syndrome is an autoimmune condition that develops in subjects who produce autoantibodies specific for type IV collagen (Borza, Neilson, and Hudson 2003). In afflicted individuals, these circulating IgG autoantibodies recognize and bind antigens present in the basement membrane of the lungs and kidneys, producing localized inflammation. In some cases, these reactions trigger widespread immune activation and vasculitis, which lead to respiratory and/or renal failure and death (Greco et al. 2015).