Abstract：
BACKGROUND:Plasma-exchange (PEX) has been well described in pediatrics, but most of the current indications are derived from adult experience. Aim of the study was to review the PEX treatments in our Unit over a six-year period. METHODS:Three hundred and seventy-seven PEX sessions were performed in 38 patients (median age 12.1 years, range 0.6-20.5). Double-needle and single-needle PEX combined with hemodialysis and PEX combined with ultrafiltration were performed in 9, 1 and 3 patients respectively. The most common indications to PEX were atypical hemolytic uremic syndrome (aHUS, 9 patients), focal segmental glomerulosclerosis (FSGS, 9 cases), antibody mediated rejection (AMR) in renal transplant (rTx) recipients (8 patients) and hyperimmunization in patients waiting for rTx (4 cases). RESULTS:We treated five patients with aHUS on native kidneys with PEX only, with complete remission in 4/6 recurrences; PEX was also successfully used to prevent HUS relapse in three patients undergoing rTx. Only one partial remission was obtained in four patients with FSGS on native kidneys, by means of treatment protocols based on PEX and immunosuppressants; conversely, a partial remission was observed in 6/6 patients with recurrence of FSGS on rTx. Immunosuppressive protocols combined with PEX proved useful in sensitized cadaveric rTx recipients (2/4 successfully transplanted), but failed in 6 patients with chronic AMR. As regards complications, two severe adverse reactions occurred: an anaphylactic shock after the use of albumin and an abdominal hemorrhage. CONCLUSIONS:PEX is a relatively safe procedure in children. Pediatric patients with aHUS, recurrent FSGS and sensitized rTx recipients seem to benefit from treatment strategies including PEX.
journal_name
Minerva Pediatrjournal_title
Minerva pediatricaauthors
Paglialonga F,Ardissino G,Consolo S,Ghio L,Belingheri M,Testa S,Biasuzzi A,Edefonti Adoi
10.23736/S0026-4946.16.04152-9subject
Has Abstractpub_date
2017-04-01 00:00:00pages
113-120issue
2eissn
0026-4946issn
1827-1715pii
R15Y9999N00A140046journal_volume
69pub_type
杂志文章abstract：BACKGROUND:Although the main treatments of inflammatory bowel disease (IBD) aim at the induction and maintenance of clinical remission, several studies have demonstrated inflammation still present in clinical remission. The goal of this study was to analyze the gene expression profiles between the pediatric IBD and con...
journal_title：Minerva pediatrica
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doi：10.23736/S0026-4946.18.04997-6
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abstract：AIM:The aim of this study was to evaluate the reaction to the procedural pain of preterm newborn and to demonstrate the different effectiveness of the two analgesic and not pharmacological techniques of recent clinical acquisition, the use of glucose solution and the sensorial saturation, in order to identify an optima...
journal_title：Minerva pediatrica
pub_type： 杂志文章,随机对照试验
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更新日期：2011-08-01 00:00:00
abstract：:The Authors describe an uncommon case of growth retardation; the clinical and radiological elements that the Authors to a diagnosis of spondyloepiphyseal dysplasia (SED) are noted; they compare this to other diagnosis of different types of growth retardation, they underline the necessity of taking these rare types int...
journal_title：Minerva pediatrica
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abstract：:Attention-deficit/hyperactivity disorder (ADHD) is a disorder characterized by persistent hyperactivity, impulsivity and inattention that impairs educational achievement and/or social development. Families seek an evaluation for children with these behaviors due to the high prevalence of ADHD and potential personal, s...
journal_title：Minerva pediatrica
pub_type： 杂志文章,评审
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更新日期：2004-12-01 00:00:00
abstract：:Insulin-dependent diabetes mellitus is associated to important micro and macro vascular complications. A good metabolic control can reduce the risk of complications. Aim of the study was to evaluate the metabolic control in adolescent diabetic patients using an educational system with graphic visualisation of capillar...
journal_title：Minerva pediatrica
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abstract：BACKGROUND:Atopic dermatitis (AD) is a very common chronic inflammatory and eczematous skin condition characterized by flares and remissions. Skin barrier alteration or dysfunction is the most relevant patogenetic factor. Topical corticosteroids are the mainstay treatment of AD, especially during flare periods. The dai...
journal_title：Minerva pediatrica
pub_type： 临床试验,杂志文章,多中心研究
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abstract：:Subjects suffering from bronchial asthma being treated with theophylline often have to be treated with an antibiotic during acute stages. The purpose of the present study is to assess to clearance variation in theophylline when a macrolide antibiotic is associated after theophyllinemia steady-state has been attained. ...
journal_title：Minerva pediatrica
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doi：
更新日期：1989-06-01 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
更新日期：1999-05-01 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
更新日期：1983-04-30 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
更新日期：2015-10-01 00:00:00
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journal_title：Minerva pediatrica
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更新日期：2009-02-01 00:00:00
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journal_title：Minerva pediatrica
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doi：
更新日期：2006-10-01 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章,评审
doi：
更新日期：2006-08-01 00:00:00
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pub_type： 杂志文章
doi：10.23736/S0026-4946.16.04358-9
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journal_title：Minerva pediatrica
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doi：
更新日期：2001-04-01 00:00:00
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journal_title：Minerva pediatrica
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doi：
更新日期：2005-06-01 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章,评审
doi：
更新日期：2010-06-01 00:00:00
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
更新日期：1998-09-01 00:00:00
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journal_title：Minerva pediatrica
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journal_title：Minerva pediatrica
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doi：
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journal_title：Minerva pediatrica
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
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journal_title：Minerva pediatrica
pub_type： 指南,杂志文章,实务指引
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journal_title：Minerva pediatrica
pub_type： 杂志文章
doi：
更新日期：2020-10-01 00:00:00
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journal_title：Minerva pediatrica
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doi：10.23736/S0026-4946.20.05842-9
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journal_title：Minerva pediatrica
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