[Pubmed] Therapeutic plasma exchange for myasthenia gravis, Guillain-Barre syndrome and other immune-mediated neurologic
Posté : 21 nov. 2022 12:00
Expert Rev Neurother. 2022 Nov 21. doi: 10.1080/14737175.2022.2147827. Online ahead of print.
ABSTRACT
BACKGROUND: Therapeutic plasma exchange (TPE) was first used in neurology in the 1980s for myasthenia gravis (MG) and Guillain-Barré syndrome (GBS). Indications have since grown. Fear of complications with this treatment modality limit its use.
RESEARCH DESIGN & METHODS: A study of patients undergoing TPE for neurological diseases (1981-2020) in a university hospital in Madrid, Spain. Clinical indications, complications, procedure number, apheresis technique and replacement fluids were prospectively recorded and retrospectively analysed. Historical trends were studied.
RESULTS: Over 40 years, 159 patients (48.69±18.15 years, 54.3% females) underwent TPE using central-venous catheter and replacement fluid albumin. We performed 1207 procedures over 189 cycles (6.4±3.8 procedures/cycle). Most patients underwent TPE for category I-II indications, mainly GBS and MG (77.7%). Complication rate was low (3.9% procedures), mostly hypotensive/vasovagal reactions (55.3%) and vascular access-related complications (38.3%). Most were mild-moderate (92.9%), permitting TPE completion, and somewhat more frequent during the first procedure (38.3%) and after periods of little TPE use. GBS patients were more prone to complications than MG patients (6.5% vs. 1.2%,p
Source: https://pubmed.ncbi.nlm.nih.gov/3640860 ... 5&v=2.17.8