scholarly journals Plasmapheresis in neurological disorders: six years experience from University Clinical center Tuzla

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1234 ◽  
Author(s):  
Osman Sinanović ◽  
Sanela Zukić ◽  
Adnan Burina ◽  
Nermina Pirić ◽  
Renata Hodžić ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Response ◽  
Plasma Exchange ◽  
Neurological Diseases ◽  
Therapeutic Plasma Exchange ◽  
Motor Neuropathy ◽  
Extracorporeal Blood Purification ◽  
Clinical Center ◽  
Plasma Factor ◽  
Neurological Patients

Background: Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique that is designed to remove substances with a large molecular weight. The TPE procedure includes removal of antibodies, alloantibodies, immune complexes, monoclonal protein, toxins or cytokines, and involves the replenishment of a specific plasma factor. The aim of the study was to describe the clinical response to TPE in various neurological patients, and to assess the clinical response to this therapy. Methods: The study was retrospective. We analyzed the medical records of 77 patients who were treated at the Department of Neurology, University Clinical Center (UCC) Tuzla from 2011 to 2016.   Results: 83 therapeutic plasma exchanges were performed in the 77 patients. There was a slight predominance of male patients (54.5%), with an average age of 51±15.9 years. The most common underlying neurological diseases were Guillain–Barré syndrome (GBS) (37.7%), then chronic inflammatory demyelinating polyneuropathy (CIDP) (23.4%), multiple sclerosis (MS) (11.7%) and myasthenia gravis (10.4%). Less frequent neurological diseases that were encountered were paraneoplastic polyneuropathies (5.2%), neuromyelitis optica (also known as Devic’s disease) (3.9%), motor neuron disease (3.9%), polymyositis (2.6%) and multifocal motor neuropathy (1.2%). Conclusions: Six years experience of therapeutic plasma exchange in neurological patients in our department have shown that, following evidence-based guidelines for plasmapheresis, the procedure was most effective in patients with GBS, CIDP and myasthenia gravis.

scholarly journals Therapeutic plasma exchange in neuroimmune diseases. Rehabilitation in myasthenia gravis patients treated with apheresis procedures

2021 ◽  
Vol 12 (Vol.12, no.1) ◽  
pp. 103-106
Author(s):  
Maria-Gabriela CATANĂ ◽  
Mihai SAVA ◽  
Corina ROMAN-FILIP
Keyword(s):  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Nicotinic Acetylcholine Receptors ◽  
Acetylcholine Receptors ◽  
Cost Effective ◽  
Therapeutic Plasma Exchange ◽  
Therapeutic Modality ◽  
Myasthenic Crisis ◽  
Class Iii ◽  
Extracorporeal Blood Purification

Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique which removes large molecular weight particles, like autoantibodies, from plasma. Double filtration plasmapheresis (DFPP) is a newer technique in which plasma is not entirely removed, only the antibodies, using special filters. Myasthenia gravis (MG) is a well-known autoimmune disease characterized by antibodies against postsynaptic nicotinic acetylcholine receptors and fluctuating weakness, sometimes life-threatening. TPE is a therapeutic modality well established in MG with a positive recommendation based on strong consensus of class III evidence and in the category I of American society for apheresis. There are no adequate randomized control trial, but many cases report short-term benefit from plasma exchange in MG especially MGC. We analyzed the cases of neuroimmune disorders that were presented to our Emergency Care Unit between 2012-2020 and we concluded that good acceptance of procedure (TPE/DFPP) was observed in 72% of patients. TPE is cost-effective rapid therapy for myasthenic crisis and progressive myasthenia gravis. It reduces ICU stays and improves outcome.All in all recent studies show that the combination of rehabilitation and other forms of treatment, appropriately selected activities contribute to alleviating the symptoms of the disease, improving physical fitness, increasing muscle strength, and thus improving the quality of life. Keywords: therapeutic plasma exchange, plasmapheresis, neuroimmune disorders,rehabilitation,

scholarly journals Therapeutic Plasma Exchange as a Treatment for Autoimmune Neurological Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ivana Nieto-Aristizábal ◽  
Álvaro J. Vivas ◽  
Pablo Ruiz-Montaño ◽  
Cristian C. Aragón ◽  
Iván Posso-Osorio ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Medical Records ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Neurological Diseases ◽  
Statistical Significance ◽  
Autoimmune Encephalitis ◽  
Therapeutic Plasma Exchange ◽  
Replacement Solution ◽  
Spectrum Disorders ◽  
Number Of Cycles

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), n = 70 (37%); Guillain–Barré syndrome (GBS), n = 53 (28.3%), neuromyelitis optica spectrum disorders (NMOSD), n = 35 (18.7%); chronic inflammatory demyelinating polyneuropathy (CIDP), n = 23 (12.2%); and autoimmune encephalitis (AE), n = 6 (3.2%). The most used types of replacement solution were albumin (n = 131, 70%) and succinylated gelatin (n = 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 (p<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.

scholarly journals Therapeutic Plasma Exchange – A 2 Years Experience at a Tertiary Care Centre in Mumbai, Maharashtra, India

2021 ◽  
Vol 10 (15) ◽  
pp. 1069-1073
Author(s):  
Moni Mukesh Udani ◽  
Akanksha Jivrag Neogi ◽  
Shweta Wasudeo Dhote ◽  
Iqbal Singh
Keyword(s):  
Plasma Exchange ◽  
Neurological Diseases ◽  
Tertiary Care ◽  
Complete Recovery ◽  
Therapeutic Plasma Exchange ◽  
Effective Procedure ◽  
Guillain Barre Syndrome ◽  
Tertiary Care Centre ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

BACKGROUND Therapeutic plasma exchange is a process where the blood collected from patient is passed through an apheresis instrument where the plasma is removed and discarded and reinfusion of blood cells done with replacement fluids like plasma or albumin to the patient.1 It is to remove pathogenic autoantibodies, immune complexes, cryoglobulins and toxins present in the plasma. Plasma exchange is considered effective and cheaper immunomodulatory treatment when compared to intravenous immunoglobulin (IVIG). 2 We present our institutional experience with therapeutic plasma exchange (TPE) in treatment of various non-neurological and neurological diseases. Our study was conducted to assess the indications, complications and outcome of TPE in the treatment of patients. METHODS A retrospective study of TPE procedures was carried out in the Department of Immunohaematology and blood transfusion, M.G.M Medical College and Hospital, Navi Mumbai from June 2018 to June 2020. A total of 45 procedures were performed among 13 patients between 4 years of age to 66 years of age. Clinical parameters were checked, and laboratory investigations were done before the procedure. Data was collected from the requisition forms by the clinicians and the apheresis database. RESULTS A total of 47 procedures were carried out among 13 patients. TPE is a safe and effective procedure for treating patients with neurologic and non-neurological diseases. Most common indication was Guillain Barre syndrome followed by myasthenia gravis. Incidence of adverse reactions was 7.6 %. CONCLUSIONS TPE is a safe and effective procedure for treating patients with neurologic and nonneurological diseases. It benefited 10 out of 13 patients, and they showed complete recovery. KEY WORDS Therapeutic Plasma Exchange, Guillain Barre syndrome

scholarly journals Therapeutic Plasma Exchange in Guillain Barre Syndrome: An experience of Bangabanhu Sheikh Mujib Medical University, Bangladesh

2022 ◽  
Vol 4 (1) ◽  
pp. 11-13
Author(s):  
Sheikh Saiful Islam ◽  
Jannatul Ferdous ◽  
Ashraful Hoque ◽  
Atiar Rahman
Keyword(s):  
Plasma Exchange ◽  
Treatment Modality ◽  
Neurological Diseases ◽  
Treatment Options ◽  
Therapeutic Plasma Exchange ◽  
Guillain Barre Syndrome ◽  
Treatment Modalities ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Medical University

Background: Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh. Materials and Methods: A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume. Results: Out of 50 cases there were 43 (86%) male and 7 (14%) female.  Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE & 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered. Conclusion: The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.

Therapeutic plasma exchange in multifocal motor neuropathy

2007 ◽  
Vol 34 (S 2) ◽  
Author(s):  
HC Lehmann ◽  
F Hoffmann ◽  
G Meyer zu Hörste ◽  
A Fußhöller ◽  
R Hetzel ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Multifocal Motor Neuropathy ◽  
Therapeutic Plasma Exchange ◽  
Motor Neuropathy

Single Donor Plasma in Therapeutic Plasma Exchange for Myasthenia Gravis

1987 ◽  
Vol 10 (5) ◽  
pp. 315-318 ◽  
Author(s):  
R. Mantegazza ◽  
E. Bruzzone ◽  
B. Regi ◽  
D. Peluchetti ◽  
M. Marconi ◽  
...  
Keyword(s):  
Side Effects ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Optimal Schedule ◽  
Therapeutic Plasma Exchange ◽  
Single Donor ◽  
Short And Long Term ◽  
Donor Plasma

Thirty-seven myasthenic patients were treated with therapeutic plasma exchange (TPE) on different performance schedules using either random or single donor plasma. The two schedules had the same effects in terms of efficacy but single donor replacement gave significantly less side effects in the short and long term. A two exchange procedure on alternate days associated with immunosuppression seems to be an optimal schedule for the treatment of myasthenic patients. A single donor two-exchange on alternate days procedure appears to be safe, useful and can be repeated in patients who need frequent TPE.

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