Lọc máu liên tục kết hợp lọc hấp phụ trong điều trị đợt cấp lupus ban đỏ hệ thống có biến chứng suy thận cấp và xuất huyết tiêu hóa nặng: Báo cáo ca bệnh

Abstract

We report a case of a 14-year-old female with active Systemic Lupus Erythematosus complicated by acute kidney injury with anuria and diffuse gastrointestinal bleeding, who was treated with continuous renal replacement therapy combined with hemoadsorption. Inflammatory markers, renal function, and hematological parameters were monitored before treatment and at 24, 48, and 72 hours. The patient demonstrated a marked decline in IL-6 levels from 612 to 68.1 pg/mL over 72 hours, while procalcitonin (PCT) decreased rapidly within the first 48 hours. Serum urea and creatinine levels progressively declined, platelet counts gradually recovered, gastrointestinal bleeding was effectively controlled, urine output resumed from day 7, and continuous renal replacement therapy was subsequently discontinued. However, given the concomitant use of multiple therapies, including high-dose corticosteroids, broad-spectrum antibiotics, blood transfusions, and intensive supportive care, a causal relationship between individual interventions and clinical improvement could not be established. Nevertheless, this case suggests that the combination of continuous renal replacement therapy and hemoadsorption may represent a potential adjunctive therapeutic strategy in severe lupus with acute kidney injury and gastrointestinal bleeding.