{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:38:29Z","timestamp":1792643909517,"version":"4.5.0"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs including kidney. Class IV lupus nephritis is the most severe form and sometimes complicated by thrombotic microangiopathy (TMA), leading to microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury (AKI). We report a 9\u2010year\u2010old female diagnosed with Class IV lupus nephritis complicated by TMA, severe AKI, and resistant hypertension. Therapeutic plasma exchange (TPE) was initiated as an adjunctive therapy due to clinical severity. A total of 15 TPE sessions were performed over 4\u2009weeks. Serial monitoring showed improvement in hematologic parameters, renal function, and clinical status. At 8\u2010month follow\u2010up, the patient maintained clinical and renal remission without relapse. This case highlights the role of prolonged, response\u2010guided TPE in severe lupus\u2010associated TMA in resource\u2010poor settings where complement\u2010targeted therapies are not available.<\/jats:p>","DOI":"10.1002\/jca.70197","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:46:41Z","timestamp":1792640801000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic Plasma Exchange in a Pediatric Lupus\u2010Associated Thrombotic Microangiopathy: Prolonged Treatment Guided by Serial Biomarker Response"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8421-0394","authenticated-orcid":false,"given":"Rituparna","family":"Bhattacharya","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine AIIMS Kalyani  Kalyani West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6229-9835","authenticated-orcid":false,"given":"Karan","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine AIIMS Kalyani  Kalyani West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1316-0666","authenticated-orcid":false,"given":"Subhankar","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics AIIMS Kalyani  Kalyani West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Shabeel","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine AIIMS Kalyani  Kalyani West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyadarsini Jayachandran","family":"Arcot","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine AIIMS Kalyani  Kalyani West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"825","DOI":"10.2215\/CJN.05780616","article-title":"Update on Lupus Nephritis","volume":"12","author":"Almaani S.","year":"2017","journal-title":"Clinical Journal of the American Society of Nephrology"},{"issue":"1","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"R12","DOI":"10.1186\/ar4142","article-title":"The Spectrum of Renal Thrombotic Microangiopathy in Lupus Nephritis","volume":"15","author":"Song D.","year":"2013","journal-title":"Arthritis Research & Therapy"},{"issue":"17","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1056\/NEJMra0902814","article-title":"Atypical Hemolytic\u2013Uremic Syndrome","volume":"361","author":"Noris M.","year":"2009","journal-title":"New England Journal of 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