Therapeutic Plasma Exchange As a Treatment for Autoimmune Neurological Disease

Overview

Journal Autoimmune Dis

Publisher Wiley

Date 2020 Aug 18

PMID 32802495

Citations 5

Authors

Ivana Nieto-Aristizabal

Alvaro J Vivas

Pablo Ruiz-Montano

Cristian C Aragon

Ivan Posso-Osorio

Jairo Quinones

Julian Alejandro Rivillas

Gabriel J Tobon

Affiliations

Soon will be listed here.

Abstract

Introduction: Therapeutic plasma exchange (TPE) is commonly used as treatment of certain autoimmune neurological diseases (ANDs), and its main objective is the removal of pathogenic autoantibodies. Our aim was to describe the clinical profile and the experience with the usage of TPE in patients with ANDs at our institution.

Methods: This is an observational retrospective study, including medical records of patients with diagnosis of ANDs who received TPE, between 2011 and 2018. Characteristics of TPE, such as number of cycles, type of replacement solution, and adverse effects, were evaluated. The modified Rankin Scale (mRS) was applied to measure the clinical response after the therapy.

Results: 187 patients were included with the following diagnoses: myasthenia gravis (MG), = 70 (37%); Guillain-Barré syndrome (GBS), = 53 (28.3%), neuromyelitis optica spectrum disorders (NMOSD), = 35 (18.7%); chronic inflammatory demyelinating polyneuropathy (CIDP), = 23 (12.2%); and autoimmune encephalitis (AE), = 6 (3.2%). The most used types of replacement solution were albumin ( = 131, 70%) and succinylated gelatin ( = 45, 24%). All patients received a median of five cycles (IQR 5-5). Hypotension and hydroelectrolytic disorders were the main complications. After TPE, 99 patients (52.9%) showed improvement in the mRS scores and a statistical significance ( < 0.05) was seen between the admission score and after TPE for every diagnosis except for CIDP.

Conclusion: TPE has an adequate safety profile, and improvement in functionality in treated patients reflects its effectiveness.

Citing Articles

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The development of the neurocritical care specialty in China based on the analysis of neurocritical care unit volume and quality.

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Feasibility, safety, and tolerability of two modalities of plasma exchange with albumin replacement to treat elderly patients with Alzheimer's disease in the AMBAR study.

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Lin Y, Oji S, Miyamoto K, Narita T, Kameyama M, Matsuo H Ther Apher Dial. 2022; 27(1):123-135.

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