Plasma Exchange during Extracapillary Glomerulonephritis at the Centre Hospitalier South Francilien, France

Objective: To describe the clinical manifestations, anatomopathology and therapeutic management of patients. Methodology: This was a retrospective prospective descriptive and analytical study of ten (10) patients followed from November 2017 to September 2024 in the nephrology department of the Centre Hospitalier South Francilien for GNEC. All patients who underwent renal puncture-biopsy with confirmation of extracapillary glomerulonephritis (ECG) were included. Results: During the course of our study, we collected 10 cases of GNEC that had benefited from plasma exchange. The mean age of our patients was 64.7 years, with extremes of 33 and 83 years. There was parity between the sexes, with a sex ratio (M/f) = 1. The circumstances of discovery were dominated by respiratory and renal manifestations, with a frequency of 80%, followed by digestive manifestations (50%). Associated comorbidities were dominated by hypertension and diabetes mellitus in 60% and 40% respectively. Two (2) or 20% of patients had creatinine levels below 500 μmol/l on admission, compared with 8 or 80% who had creatinine levels above 500 μmol/l on admission. The mean creatinine level was 726 μmol/l on admission, compared with 251 μmol/l after treatment, for a total reduction of more than 50% in 8 out of 10 patients. The etiology of GNEC was dominated by anti MPO/PR3 ANCA vasculitis in 50% of cases, anti MBG ANCA vasculitis in 30% followed by IgA nephropathy and Cryoglobulinemia in 10% each. All our patients benefited from immunosup-pression and corticosteroid boluses. Five patients benefited from hemodialysis. Conclusion: GNEC is a serious condition, not uncommon in our setting. The most frequent mode of onset was GNRP. The vital prognosis of this pathology remains unfavorable without treatment. Early detection and appropriate management by qualified medical staff could considerably reduce the morbidity and mortality associated with this disease.