For substantial rate of cases who are resistant to standard Glucocorticoids therapy, plasma exchange (PE) sometimes brings about complete remission. A case with severe BP successfully treated in combination of steroid and PE is reported with the follow up data of the change of symptom and serum levels of BP antibody. Case report: 52-year-old woman visited dermatology department with complain of severe systemic itching due to which she scratched whole body all day PCI32765 long for 4 months. During next two months, systemic erythematous,

pruritic, painful rashes developed, and tense blisters over hands and fingers, which didn’t resolve spontaneously. Slight improvement of rash was obtained under antihistamine agents, topical steroids and 1 mg/day of betamethasone, however, new erythema and papular rash still continued emerging and she was admitted to hospital. Her blood test showed scale over level of high anti BP180 antibody. Skin biopsy showed subepidermal blister and infiltlation of eosinocytes by light microscopy, and linear staining of IgG and C3 along with basement membrane by immunofluorescent microscopy. From these data, severe BP was diagnosed. Hospital coarse: 40 mg of

Fostamatinib cell line oral prednisolone combining with 3 day methylprednisolone pulse therapy was started, however, failed to stop blisters emerging. 15 days after steroid monotherapy, PE (3000 ml of plasma change for 3 hours a day) was started. After 1st exchange severe itching with blisters rapidly decreased, and almost disappeared after 8th exchange. On the other hand, serum BP180 antibody level remained high until 9th exchange when it became under the scale measurable. Sinomenine 57 days after 10 times of PE, she was discharged on oral 1.5 mg of betamethasone and 50 mg of mizoribine per day. Conclusion: Rapid symptomatic

relief of BP is expected by PE, before disappearance of serum BP antibody possibly through the remove of chemical or inflammatory substances in plasma. BUNANI EUNICE, DUMDUM1, BUNANI ARCHIE2 1Cagayan de Oro Medical Center; 2Southwestern University College of Medicine Background: Effective heparinization during dialysis is vital since it allows blood to flow into the extracorporeal circuit. Objective: This study aimed to develop a relationship between errors in Heparin administration and the study of Partial Thromboplastin Time (PTT), Hemoglobin (Hgb), Hematocrit (Hct), and Platelet levels (Plt) of hemodialysis (HD) patients. Methods: 96 pediatric HD patient records were examined for compliance and errors in heparin administration practices (mean age is 15.6). With multiple tendencies, cox regression was used to analyze trends whilst Pearson rho moment correlation determined relationships.