Therapeutic plasma exchange in the treatment of neuroimmunologic disorders: review of 50 cases

Autor(es): Yücesan Canan,Arslan Onder,Arat Mutlu,Yücemen Nezih,Ayyildiz Erol,Ilhan Osman,Mutluer Nermin

Resumo: Therapeutic plasma exchange (TPE) has been used for the treatment of neurologic diseases in which autoimmunity plays a major role. We reviewed the medical records of our patients who had consecutively been treated by TPE between January 1998 and June 2000. Neurological indications included myasthenia gravis (30 patients), multiple sclerosis attack (6 patients with remitting-relapsing course and 3 patients with secondary progressive course), Guillain-Barrè syndrome (6 patients), paraproteinemic neuropathy (2 patients), and chronic inflammatory demyelinating neuropathy (CIDP), transverse myelitis due to systemic lupus erythematosus, acute disseminated encephalomyelitis in one patient each. Continuous flow cell separators were used for TPE. TPE was generally given every other day for all of the patients and one plasma volume was exchanged for each cycle. Although the patients with secondary progressive multiple sclerosis (3 patients) and paraproteinemic neuropathy (2 patients) did not show any improvement after TPE, other patients' targeted neurological deficits were improved by TPE. During the TPE procedures, no patient had any morbidity or mortality, and the complications were mild and manageable such as hypotension, hypocalcemia and mild anemia; three patients had septicemia due to the venous catheter used for TPE. TPE is an effective treatment in neurologic diseases in which autoimmunity plays an important role in pathogenesis, and it is safe when performed in experienced centers.

Palavras-Chave: Therapeutic plasma exchange (TPE); Myasthenia gravis; Multiple sclerosis; Guillain-Barrè syndrome; Paraproteinemic neuropathy; Chronic inflammatory demyelinating neuropathy (CIDP); Transverse myelitis; Acute disseminated encephalomyelitis

Imprenta: Transfusion and Apheresis Science, v. 36, n. 1, p. 103-107, 2007

Identificador do objeto digital: 10.1016/j.transci.2006.06.008

Descritores: Guillain-Barre Syndrome - Cell ; Guillain-Barre Syndrome - Pathogenesis ; Guillain-Barre Syndrome - Autoimmunity ; Guillain-Barre Syndrome - Inflammation ; Guillain-Barre Syndrome - Public health

Data de publicação: 2007