scholarly journals Therapeutic Plasma Exchange in Patients with Systemic Lupus Erythematosus

2020 ◽  
Vol 20 (02) ◽  
pp. 65-70
Author(s):  
Cheuk Man Ho ◽  
Chi Chiu Mok
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
Organ Damage ◽  
Therapeutic Plasma Exchange ◽  
Current Evidence ◽  
Systemic Lupus ◽  
Level Of Evidence ◽  
Multiple Systems ◽  
Life Threatening

Systemic lupus erythematosus (SLE) is an autoimmune disease with involvement of multiple systems. Despite the therapeutic advances in the past few decades, refractory SLE causing organ damage and life-threatening complications still poses a therapeutic challenge. Therapeutic plasma exchange is considered as one of the rescue therapies used in refractory SLE. However, the level of evidence supporting its use is low. This article reviews the current evidence of the application of plasmapheresis in the treatment of SLE.

Toxic epidermal necrolysis after therapeutic plasma exchange in pediatric lupus patients and associated risk factors analysis

Lupus ◽  
2021 ◽  
pp. 096120332098112
Author(s):  
Jing Lu ◽  
Liqun Dong ◽  
Lijuan Zhang ◽  
Hui Zhang ◽  
Lin Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Toxic Epidermal Necrolysis ◽  
Plasma Exchange ◽  
Skin Rash ◽  
Lupus Erythematosus ◽  
Effective Means ◽  
Clinical Manifestations ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus

Background Therapeutic plasma exchange (TPE) is an effective means of treating systemic lupus erythematosus in children and is safe for most pediatric patients with systemic lupus erythematosus, but severe complications such as toxic epidermal necrolysis (TEN) may occur, which is a life-threatening condition. Methods In this study, three systemic lupus erythematosus (SLE) children developed toxic epidermal necrolysis after TPE. We analyzed their medical history, clinical manifestations, SLEDAI scores, and immunological characteristics, compared to 117 cases of SLE patients without TEN after TPE, trying to find the possible risk factors. Results The three children with TEN after plasma exchange appeared to have a higher proportion of male (male: female = 2:1), fever (100% Vs 32.5%), erythema on the cheek (100% Vs 54.7%), itching rash (100% Vs 54.7%), ruptured rash (100% Vs 54.7%), oral ulcer (100% Vs 54.7%) and higher LDH level (1826.0 ± 1113.1 Vs 721.1 ± 799.5 U/L), but lower white blood cell count (5.5 ± 3.3 Vs 7.2 ± 4.2 × 109/L), neutrophil count (4.7 ± 3.7 Vs 5.2 ± 3.6 × 109/L), lymphocyte count (0.6 ± 0.5 Vs 1.5 ± 0.8 × 109/L), platelet count (133.7 ± 58.1 Vs 178.5 ± 103.1 × 109/L) and C-reactive protein (all normal Vs 47.9% elevated). Autoantibody spectrum revealed that positive anti-SSA seemed more common (100% Vs 42.7%) in the three children. Relative risk analysis revealed that male (OR 21.4, 95%CI 1.78–257.186), ruptured skin rash (OR 56.5, 95%CI 4.199–760.196) and rash with itching (OR 24, 95%CI 1.98–290.896) are the risk factors of SLE patients developing TEN after plasma exchange. Conclusions We should pay particular attention to TEN after plasma exchange in SLE patients (3/120, 2.5%). This condition may be related to male, ruptured skin rash and rash with itching. For SLE patients with risk factors. We should arrange plasmapheresis more carefully.

scholarly journals Therapeutic Plasma Exchange as Management of Complicated Systemic Lupus Erythematosus and Other Autoimmune Diseases

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
David Aguirre-Valencia ◽  
Juan Naranjo-Escobar ◽  
Iván Posso-Osorio ◽  
María Carmenza Macía-Mejía ◽  
Ivana Nieto-Aristizábal ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Autoimmune Diseases ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Diffuse Alveolar Hemorrhage ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus ◽  
Systemic Autoimmune Diseases ◽  
Main Complication

Introduction. Autoimmune diseases include a diverse and complex group of pathologies with a broad clinical spectrum due to the production of autoantibodies, which generates multisystemic compromise. Therapeutic plasma exchange (TPE) is a good additive treatment for immunosuppression due to its action over the autoantibodies. Objectives. To describe the main clinical characteristics and outcomes of patients with systemic lupus erythematosus and other systemic autoimmune diseases managed with TPE. Methodology. This descriptive retrospective study enrolled patients with systemic autoimmune diseases who received TPE. Results. In total, 66 patients with a median age of 33.5 years (24-53 years) were included; the majority were females [n=51 (77.27%)]. Forty (60.61%) patients were diagnosed with systemic lupus erythematosus. In these cases, the main indication for TPE was diffuse alveolar hemorrhage (DAH; n=20, 30.3%) and neurolupus (n=9, 13.6%). No TPE-related deaths occurred, and the main complication was hemorrhage, without significant differences among the four types of TPE solutions used. The overall outcome was improvement in 41 (62.12%) patients. Conclusion. TPE is safe and effective in patients with severe manifestations of autoimmune diseases.

scholarly journals AB0132 ALTERATIONS IN PERIPHERAL T-CELLS AND B-CELLS SUBSETS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN’S SYNDROME UNDERGOING THERAPEUTIC PLASMA EXCHANGE OR IMMUNOADSORPTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1367.2-1367
Author(s):  
Y. Jiang ◽  
Q. Wei ◽  
Q. Lv ◽  
X. Zhang ◽  
W. Zhu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
T Cell ◽  
B Cells ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus

Background:Systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SS) are systemic autoimmune diseases characterized by a broad spectrum of clinical manifestations and disease course. Alternative therapies such as therapeutic plasma exchange (TPE), immunoadsorption are recommended to the patients who lack a good response to standard therapy [1].Objectives:Our observational study was to explored whether abnormalities in T-cells, B-cells and their subtypes were present in the patients who had TPE or immunoadsorption in patients with SLE and SS compared with healthy controls (HC).Methods:Demographic, clinical variables and autoantibodies were recorded. Flow cytometry was used to establish the frequencies of lineage subsets. Monoclonal antibodies against 21 surface markers such as CD3, CD4, CD8, were used to distinguish and evaluate T-cells’ and B-cells’ subpopulation. SLE acvity was measured using systemic lupus erythematosus disease activity index (SLEDAI). Comparisons between subgroups were undertaken using paired T-test, Mann-Whitney U test and ANOVA.Figure 1.Altered expression of CD4+ T-cell subsets in the patients with SLE and SS after treated with plasma exchange or immunoadsorptionResults:6 SS patients and 1 SLE patient underwent immune adsorption, while the other 5 SLE patients had plasma exchange all for three times. There was no significant difference among SLE, SS and HC in the proportion of T-cells and B-cells. The proportion of CD3-CD19+CD27+IgD+ B-cells were reduced in SLE, while CD3+CD4+CD25+CD127- T-cells were elevated in SS. The proportion of CD3+CD4+CD45RA+CCR7+T-cells were increased (p= 0.045), while CD3+CD4+CD25+CD127- T-cells were declined (p= 0.027) and CD3+CD4+CXCR5+PD-1+ T-cells went down after the therapies (p≤ 0.030). The proportion of CD3-CD19+IgD-IgM-CD27+CD38+ B-cells was also reduced after TPE or immunoadsorption (p= 0.032) with ANA titers and IgG decreasing dramatically. SLEDAI scores were reduced after the therapy in SLE patients.Conclusion:The T-cell and B-cell’s profiles were proved to have alteration after TPE or immunoadsorption which shed light on the complicated mechanisms of these relatively novel therapy in SLE and SS.References:[1]Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. ANN RHEUM DIS 2012;71:1771-1782.Acknowledgments:None.Disclosure of Interests:None declared

Therapeutic plasma exchange and Cyclosporin A in severe systemic lupus erythematosus

1989 ◽  
Vol 10 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Rolf Bambauer ◽  
Bernd Reinelt ◽  
Hans Pees ◽  
Gerhard Schwarze ◽  
Hans Erich Keller ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cyclosporin A ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus ◽  
Severe Systemic Lupus Erythematosus

scholarly journals Systemic lupus erythematosus in a male patient in lower Assam

2022 ◽  
pp. 529-531
Author(s):  
F Altous ◽  
Rupak Protim Patir ◽  
Debashish Kharigapsha ◽  
Bimal Karmakar ◽  
Mozadeed Alom
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Inflammatory Disorder ◽  
Systemic Lupus ◽  
Multiple Systems ◽  
Male Ratio ◽  
Wide Range ◽  
Life Threatening ◽  
High Index Of Suspicion

Systemic lupus erythematosus (SLE) is one of the numerous diseases called “the great imitators” because it frequently resembles or is misdiagnosed as other illnesses. SLE is a chronic autoimmune inflammatory disorder that affects multiple systems and has a wide range of symptoms. The female to male ratio varies between 7 and 15 to 1. A number of observations point to an estrogen impact as the cause of this variance. Because sex hormonal impacts are likely to be modest in youngsters, the female to male ratio is 3:1. Renal involvement and seizures are more common in male SLE patients than photophobia and cutaneous symptoms. Males likewise appear to have a more devastating consequence. As a result, we feel that male lupus patients are uncommon, the illness’s symptoms are life-threatening, and that early discovery of the disease will result in a better outcome for these patients. Here, we report the case of SLE with an unusual presentation in a 44-year-old man from lower Assam to emphasize the importance of a high index of suspicion in such patients.

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