Plasmapheresis in rapidly progressive Henoch-Schoenlein glomerulonephritis and the effect on circulating IgA immune complexes

Two adult patients with Henoch-Schoenlein purpura and rapidly progressive glomerulonephritis were treated with plasmapheresis. One patient also received cyclophosphamide. Both patients recovered their renal function. Before plasmapheresis circulating IgA immune complexes were demonstrated in both patients by two assays with specificity for IgA. The level of IgA immune complexes decreased after each plasma exchange. IgA immune complexes disappeared in the patient who was treated with cyclophosphamide but remained present in the other patient. Plasma exchange may be a useful form of therapy for patients with Henoch-Schoenlein purpura and progressive renal failure. Measurement of circulating IgA immune complexes may provide insight into the in vivo effect of plasmapheresis.