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Mishra AP, Sahoo SK, Kanungo G, Sahoo LK, Mishra S, Mishra C. Therapeutic Plasma Exchange in Neurological Conditions: An Observation from the Eastern Part of India. Ann Afr Med 2024; 23:649-655. [PMID: 39279168 DOI: 10.4103/aam.aam_65_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/18/2024] [Indexed: 09/18/2024] Open
Abstract
INTRODUCTION Therapeutic plasma exchange (TPE) is an extracorporeal process of separation of plasma from the cellular components of blood and its replacement with analogous fluids. This process is effective in treatment of disease conditions from dysregulation of the humoral immune system by removal of various humoral pathogenic substances like antibodies, immune complexes, monoclonal proteins, toxins or cytokine(s) and/or the replenishment of a specific plasma factor. AIM AND OBJECTIVE To evaluate major indications of therapeutic plasma exchange in neurological disorders. To identify major complications associated and factors associated with premature cessation of the therapeutic plasma exchange cycle. Materials and Methods: This is a hospital based retrospective study conducted by analyzing medical records of patients, who had undergone therapeutic plasma exchange (TPE) for various neurological disorders at IMS & SUM hospital. Medical records total 118 patients who underwent TPE from January 2016 to December 2021 were analyzed. The demographic data, blood group pattern and indications for TPE were enumerated from the records. Various complications of TPE and reasons for incomplete TPE cycle were documented and analyzed. RESULTS A total of 508 TPE procedures were performed on 118 patients. In this study 61 patients were male and 57 patients were female. O-blood group was commonest blood group among the patients. GBS is the commonest indication of TPE. 57.6 % of patients could complete all sessions TPE cycle. Blockage of vascular access is the commonest cause of incomplete TPE session. Cramps (33%) and mild transient hypotension (27.1%0 were the commonest complications observed. CONCLUSION TPE is a safe and effective treatment option for various immune-mediated neurological disorders and should be considered in managing these disorders.
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Affiliation(s)
- Ajit Prasad Mishra
- Department of Neurology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | | | - Girijanandini Kanungo
- Department of Transfusion Medicine, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Lulup Kumar Sahoo
- Department of Neurology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Shubhankar Mishra
- Department of Neurology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
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Ramirez S, Koerich S, Astudillo N, De Gregorio N, Al-Lahham R, Allison T, Rocha NP, Wang F, Soto C. Plasma Exchange Reduces Aβ Levels in Plasma and Decreases Amyloid Plaques in the Brain in a Mouse Model of Alzheimer's Disease. Int J Mol Sci 2023; 24:17087. [PMID: 38069410 PMCID: PMC10706894 DOI: 10.3390/ijms242317087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia, characterized by the abnormal accumulation of protein aggregates in the brain, known as neurofibrillary tangles and amyloid-β (Aβ) plaques. It is believed that an imbalance between cerebral and peripheral pools of Aβ may play a relevant role in the deposition of Aβ aggregates. Therefore, in this study, we aimed to evaluate the effect of the removal of Aβ from blood plasma on the accumulation of amyloid plaques in the brain. We performed monthly plasma exchange with a 5% mouse albumin solution in the APP/PS1 mouse model from 3 to 7 months old. At the endpoint, total Aβ levels were measured in the plasma, and soluble and insoluble brain fractions were analyzed using ELISA. Brains were also analyzed histologically for amyloid plaque burden, plaque size distributions, and gliosis. Our results showed a reduction in the levels of Aβ in the plasma and insoluble brain fractions. Interestingly, histological analysis showed a reduction in thioflavin-S (ThS) and amyloid immunoreactivity in the cortex and hippocampus, accompanied by a change in the size distribution of amyloid plaques, and a reduction in Iba1-positive cells. Our results provide preclinical evidence supporting the relevance of targeting Aβ in the periphery and reinforcing the potential use of plasma exchange as an alternative non-pharmacological strategy for slowing down AD pathogenesis.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Claudio Soto
- Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston, TX 77030, USA; (S.R.); (S.K.); (N.A.); (N.D.G.); (R.A.-L.); (T.A.); (N.P.R.); (F.W.)
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Zhang W, Jiao Y, Cui L, Zhang Y, Jiao J, Jin M, Yuan W, You Y, Wang R, Peng D. Therapeutic efficacy and safety of plasmapheresis in elderly patients with neuromyelitis optica spectrum disorder: a single-center observational study. Ther Adv Neurol Disord 2023; 16:17562864231162420. [PMID: 36993936 PMCID: PMC10041617 DOI: 10.1177/17562864231162420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/21/2023] [Indexed: 03/31/2023] Open
Abstract
Background Neuromyelitis optica spectrum disorder (NMOSD) is a devastating autoimmune disorder with cycles of escalating relapse. Rates of diagnosis in the elderly are increasing. Therapeutic decision-making is more challenging in elderly patients due to multiple comorbidities and high risk of drug-induced side effects. Objective This retrospective study assessed the efficacy and safety of standard plasma exchange (PLEX) treatment in an elderly population with NMOSD. Design Seventy-six patients with NMOSD who received PLEX were apportioned to two groups as either elderly (⩾60 years, n = 26) or young (<60 years) at the time of the first procedure. Methods Therapeutic response was judged according to functional recovery at 6 months, as reflected by Expanded Disability Status Scale (EDSS) and visual outcome scale (VOS) scores. Results The mean age of the 26 elderly patients was 67.7 ± 7.9 years (range 60-87 years); the population was predominantly female (88.5%). PLEX sessions were generally well tolerated among the elderly. Compared with the young patients, the elderly had significantly more comorbidities and concomitant medications. Twenty-four (96.0%) elderly patients showed functional improvement at 6 months after PLEX, of which 15 (60.0%) experienced moderate-to-marked improvement. Six months after the initial PLEX treatment, the patients overall experienced a significant improvement in EDSS and VOS scores. Logistic regression showed that severe optic neuritis attack was a significant independent prognostic factor associated with poor PLEX response. The groups were comparable regarding overall or serious adverse events. The rate of transient hypotension was significantly higher in the elderly compared with the young. Conclusion PLEX is an effective and safe therapy for elderly patients with NMOSD and should be considered a treatment option during NMOSD attacks. In the elderly, preventive measures against hypotension are recommended before PLEX.
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Affiliation(s)
| | - Yujuan Jiao
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Lei Cui
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Yeqiong Zhang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Jinsong Jiao
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Ming Jin
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Wei Yuan
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Yang You
- Department of Neurology, No. 964 Hospital of People’s Liberation Army, Changchun, China
| | - Renbin Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Dantao Peng
- Department of Neurology, China-Japan Friendship Hospital, 2 Yinghua, Dongjie, Hepingli, Beijing 100029, China
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Shaka H, El-amir Z, Jamil A, Kwei-Nsoro R, Wani F, Dahiya DS, Kichloo A, Amblee A. Plasmapheresis in hypertriglyceridemia-induced acute pancreatitis. Proc (Bayl Univ Med Cent) 2022; 35:768-772. [DOI: 10.1080/08998280.2022.2106531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Affiliation(s)
- Hafeez Shaka
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
| | - Zain El-amir
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
| | - Abdul Jamil
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
| | - Robert Kwei-Nsoro
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
| | - Farah Wani
- Department of Medicine, Samaritan Medical Center, Watertown, New York
| | - Dushyant Singh Dahiya
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
| | - Asim Kichloo
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
- Department of Medicine, Samaritan Medical Center, Watertown, New York
| | - Ambika Amblee
- Division of Endocrinology, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
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Abstract
Guillain-Barré syndrome (GBS) is an acute autoimmune neuropathy that can cause motor, sensory, and autonomic symptoms. Although GBS primarily is a neuropathic disorder, multiple organ systems can be affected during the disease course, and older patients may be more vulnerable to systemic complications. Close clinical monitoring and early interventions using pharmacologic and nonpharmacological treatments may lead to an improved long-term outcome.
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Affiliation(s)
- Justin Kwan
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10, Room 1D45, MSC 1140, 10 Center Drive, Bethesda, MD 20814, USA.
| | - Suur Biliciler
- Department of Neurology, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSE#466, Houston, TX 77030, USA
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Soares Ferreira Júnior A, Boyle SH, Kuchibhatla M, Akinyemiju T, Onwuemene OA. Use of therapeutic plasma exchange in heparin-induced thrombocytopenia: A population-based study. J Clin Apher 2021; 36:398-407. [PMID: 33453132 DOI: 10.1002/jca.21876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Heparin-induced thrombocytopenia (HIT) is characterized by anti-heparin/platelet factor 4 immune complexes, which are removed by therapeutic plasma exchange (TPE). Our main objective was to study TPE outcomes in HIT using a large administrative claims database. STUDY DESIGN AND METHODS We used the National Inpatient Sample (NIS) to identify hospital discharges of adult patients (≥18) with a primary or secondary diagnosis of HIT. Cases were classified into two groups based on TPE use. The primary outcome was in-hospital mortality. Secondary outcomes were thrombotic events, major bleeding, hospital length of stay (LOS), and charges. Multivariable regression analysis, controlling for age and medical comorbidities, was used to examine the association of TPE with study outcomes. RESULTS A HIT diagnosis was made in 22 165 discharges, of which 90 (0.4%) received TPE. Corresponding national estimates are 106 435 and 439, respectively. TPE was not associated with decreased in-hospital mortality (OR = 1.72; 95%CI: 0.93-3.17, P = .085). However, TPE was associated with a higher likelihood of major bleeding (OR = 2.35; 95%CI: 1.40-3.68, P = .0009), primarily driven by gastrointestinal bleeding (OR = 2.21; 95%CI: 1.17-4.17, P = .015). TPE was also associated with higher hospital LOS (20.5 vs 10 day, P < .0001) and charges (USD 211181 vs USD 81654, P < .0001). CONCLUSION TPE's association with increased bleeding and a prolonged hospital course indicates that it is being used in HIT cases with a severe clinical phenotype. Future studies are needed to better characterize the HIT phenotype that will most benefit from TPE.
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Affiliation(s)
| | - Stephen H Boyle
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Maragatha Kuchibhatla
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tomi Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Oluwatoyosi A Onwuemene
- Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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Volkova L, Toporkova M, Galunova A, Sokolova L. Clinical features of myasthenia gravis in elderly and senile patients. BIO WEB OF CONFERENCES 2020. [DOI: 10.1051/bioconf/20202201018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The prevalence of myasthenia gravis is 10-24 cases per 100, 000 population. The debut of the disease is possible at any age: from infancy to old age. In the literature, the definition of “myasthenia gravis with late onset” – at the age of 60 years and older, which is 20-46% of all cases. In this regard, the disease is often combined with a burdened somatic history, which makes it difficult to timely diagnosis and treatment. This group of elderly patients accounts for the majority of diagnostic errors in the diagnosis of myasthenia gravis. This study is devoted to the study of the features of the onset and course of myasthenia gravis in elderly and senile people.
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Das J, Chauhan VD, Mills D, Johal NJ, Tan M, Matthews R, Keh R, Lilleker JB, Gosal D, Sharaf N. Therapeutic plasma exchange in neurological disorders: Experience from a tertiary neuroscience centre. Transfus Apher Sci 2019; 58:102654. [PMID: 31648858 DOI: 10.1016/j.transci.2019.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/13/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022]
Abstract
Therapeutic plasma exchange (TPE) involves the extracorporeal separation of plasma from the cellular components of blood with replacement fluid, such as human albumin or fresh frozen plasma. A number of studies across the world revealed that more than one third of TPE procedures were performed for neurological disorders. Myasthenia gravis (MG), Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) were the most frequently cited indications for TPE, followed by multiple sclerosis (MS). However, treatments of these conditions have evolved over the years and it is likely that this has impacted on clinical practice. Here we present our experience of using TPE to treat neurological disorders. We reviewed the medical records of all 63 patients who received 349 procedures over 70 therapeutic cycles between 2012 and 2015 in a tertiary neurology centre. In total only 2 patients with GBS and MG were treated with TPE. The commonest indication was voltage gated potassium channel (VGKC) complex antibody associated disorders followed by CIDP and MS. There were 11 patients with limbic encephalitis. Nine of them had antibodies against VGKC complex and two had N-methyl-D-aspartate (NMDA) receptor antibodies. Sixty four percent of patients with limbic encephalitis and overall 78% of patients responded to TPE. The complication rate associated with this procedure was 8.6 per 100 therapeutic cycle. There was no treatment related mortality. We observed a change in indications of TPE compared to historical studies. It was less frequently used to treated GBS and MG. It was found to be safe and effective.
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Affiliation(s)
- Joyutpal Das
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
| | - Vanisha D Chauhan
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
| | - Daniel Mills
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
| | - Nicholas J Johal
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
| | - Maevis Tan
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
| | - Rachael Matthews
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
| | - Ryan Keh
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
| | - James B Lilleker
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK; Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - David Gosal
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
| | - Nazar Sharaf
- Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
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Baruah S, Periyavan S. Adverse effects of intermittent flow therapeutic plasmapheresis in neurology patients in a resource constrained setting. GLOBAL JOURNAL OF TRANSFUSION MEDICINE 2019. [DOI: 10.4103/gjtm.gjtm_1_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ahammed Nizar OT, Rai P, Rao SN, Shenoy MP. Plasmapheresis: A Retrospective Audit of Procedures from a Tertiary Care Center in Southern India. Indian J Crit Care Med 2018; 21:857-860. [PMID: 29307968 PMCID: PMC5752796 DOI: 10.4103/ijccm.ijccm_177_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction: The term plasmapheresis/plasma exchange refers to the removal of the plasma component of blood and its replacement with various fluids. Plasma Exchange (PE) has been used to treat a variety of conditions that are associated with an aberrant immune response. We undertook this retrospective study aiming to look at plasmapheresis procedures conducted in the nephrology department over a fixed time period. Materials and Methods: Retrospective analysis of PE procedures from January 2013 to October 2016 was conducted in the nephrology and Intensive Care Unit of a tertiary care teaching hospital. The goal was to achieve a total removal of 150–200 ml/plasma per kg body weight. As replacement, we used a standard protocol of 100 ml of 20% albumin in 1 L of normal saline and 2–3 units of fresh frozen plasma. All results were expressed as mean ± standard deviation and statistical analysis was done using the Student's t-test for continuous and Fisher's exact test for categorical data. Results: A total of 192 procedures performed on 40 patients (22 males and 18 females). Age ranged from 15 to 79 years with a mean age of 37.5 years. Guillain–Barre syndrome accounted for 67.5% (>two-third of causes) for PE. Vascular access was femoral catheter in 27 (67.5%) and internal jugular catheter in 13 (32.5%). Mild hypotension occurred in 15 procedures (7.8%) of patients and allergic reactions such as rashes and chills occurred in 5 cycles (2.6%). A total of 36 patients (90%) showed significant improvement in condition, 2 did not show any change, while one worsened and one died due to respiratory complications. Conclusion: Our small series of data of plasmapheresis procedures from nephrology perspective has reaffirmed the safety and efficacy of the therapy in an experienced setup.
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Affiliation(s)
- O T Ahammed Nizar
- Department of Internal Medicine, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Pratheeksha Rai
- Department of Internal Medicine, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Shobhana Nayak Rao
- Department of Nephrology, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - M Pradeep Shenoy
- Department of Nephrology, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
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Brunetta Gavranić B, Bašić-Jukić N, Kes P. Therapeutic Plasma Exchange-Does Age Matter? A Single-Center Study. Artif Organs 2016; 40:786-92. [DOI: 10.1111/aor.12674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Bruna Brunetta Gavranić
- Departments of Nephrology, Arterial Hypertension, Dialysis and Transplantation; Department of Internal Medicine; University Hospital Centre Zagreb; Zagreb Croatia
| | - Nikolina Bašić-Jukić
- Departments of Nephrology, Arterial Hypertension, Dialysis and Transplantation; Department of Internal Medicine; University Hospital Centre Zagreb; Zagreb Croatia
| | - Petar Kes
- Departments of Nephrology, Arterial Hypertension, Dialysis and Transplantation; Department of Internal Medicine; University Hospital Centre Zagreb; Zagreb Croatia
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Gafoor VA, Jose J, Saifudheen K, Musthafa M. Plasmapheresis in neurological disorders: Experience from a tertiary care hospital in South India. Ann Indian Acad Neurol 2015; 18:15-9. [PMID: 25745304 PMCID: PMC4350207 DOI: 10.4103/0972-2327.144301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 07/17/2014] [Accepted: 07/18/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Therapeutic plasma exchange (PE) or plasmapheresis is the treatment of choice in many neurological disorders. Even though it is safe in experienced hands, there is a major concern about its safety among physicians. OBJECTIVES To analyze our experience with 230 patients who underwent PE for various neurological disorders. MATERIALS AND METHODS Retrospective review of PE procedures done during a period of 48 months, from July 2007 to June 2011 in a tertiary care teaching hospital in South India. Indications, clinical results and technical factors are discussed. RESULTS The main indication for PE was GBS (203 patients; 88.3%). Age of patients ranged from 14-65 (mean = 42.3 years). The most common complications were paraesthesias and/or cramps (36.1%) and hypotension (32.2%). Four pregnant patients who underwent PE had good recovery with one intrauterine death. There was no mortality. CONCLUSION The analysis of 240 cases of PE done in our department shows that the procedure is safe, with only minimal procedure related complications and no mortality.
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Affiliation(s)
- V Abdul Gafoor
- Department of Neurology, Medical College, Calicut, Kerala, India
| | - James Jose
- Department of Neurology, Medical College, Calicut, Kerala, India
| | - K Saifudheen
- Department of Neurology, Medical College, Calicut, Kerala, India
| | - Mohamed Musthafa
- Department of Neurology, Medical College, Calicut, Kerala, India
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Therapeutic plasmapheresis in geriatric patients: favorable results. Transfus Apher Sci 2014; 51:64-7. [PMID: 25457004 DOI: 10.1016/j.transci.2014.10.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/24/2014] [Accepted: 10/07/2014] [Indexed: 11/22/2022]
Abstract
Therapeutic plasma exchange is generally a tolerable procedure, although several complications should be considered. Since geriatric population has been growing worldwide, the aim of this study was to retrospectively analyze 4709 TPE data from 981 geriatric procedures (20.8%) and to compare them with 3728 non-geriatric procedures (79.2%). The most common indications for TPE in both groups were sepsis/adult respiratory distress syndrome and multiple organ dysfunction. In geriatric patient group, contrary to expectations of aggravation, complication rate was statistically similar with non-geriatric group (P > 0.05). Therefore, TPE appeared to be a safe procedure in geriatric patients when performed by experienced practitioners.
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Treatment of NMO relapse in the elderly: rituximab when plasma exchange fails? Acta Neurol Belg 2013; 113:335-6. [PMID: 23358962 DOI: 10.1007/s13760-013-0178-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/03/2013] [Indexed: 01/19/2023]
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Abdel-Rahman EM, Balogun RA. Therapeutic apheresis in the elderly: an update. J Clin Apher 2013; 28:84-6. [PMID: 23420599 DOI: 10.1002/jca.21259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 01/15/2013] [Indexed: 11/07/2022]
Abstract
Therapeutic apheresis medicine comprises many procedures, the most common being therapeutic plasma exchange (TPE). There is wide acceptance and use of TPE in the treatment of disease conditions that cut across several organ systems in the body and affect patients of various age groups. Patients that are 65 years or older form a significant cohort with increasing need for TPE. This brief report addresses special considerations in this cohort with useful comparisons made with younger cohorts as presented in the Therapeutic Apheresis Academy at the University of Virginia in September 2012.
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Affiliation(s)
- Emaad M Abdel-Rahman
- Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
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Ebadi H, Barth D, Bril V. Safety of plasma exchange therapy in patients with myasthenia gravis. Muscle Nerve 2013; 47:510-4. [DOI: 10.1002/mus.23626] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2012] [Indexed: 12/17/2022]
Affiliation(s)
- Hamid Ebadi
- Division of Neurology, University Health Network; University of Toronto; 5EC-309, 200 Elizabeth Street Toronto Ontario M5G 2C4 Canada
| | - David Barth
- Division of Hematological Pathology, Department of Laboratory Medicine; University Health Network, University of Toronto; Toronto Ontario Canada
| | - Vera Bril
- Division of Neurology, University Health Network; University of Toronto; 5EC-309, 200 Elizabeth Street Toronto Ontario M5G 2C4 Canada
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Živković SA, Clemens PR, Lacomis D. Characteristics of late-onset myasthenia gravis. J Neurol 2012; 259:2167-71. [DOI: 10.1007/s00415-012-6478-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/04/2012] [Accepted: 03/05/2012] [Indexed: 12/27/2022]
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Abdel-Rahman EM, Hayes J, Balogun RA. Therapeutic plasma exchange in the elderly: Experience at a tertiary center. J Clin Apher 2012; 27:108-11. [DOI: 10.1002/jca.21220] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 02/21/2012] [Indexed: 01/11/2023]
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Hayes JS, Balogun RA, Chang J, Abdel Rahman EM. Therapeutic Plasma Exchange for Renal-Related Conditions in the Elderly: Ten Years Experience in One Center. Semin Dial 2012; 25:159-64. [DOI: 10.1111/j.1525-139x.2011.01027.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Brunetta Gavranić B, Bašić-Jukić N, Kes P. Changes in Indications for Therapeutic Plasma Exchange Over the Last 27 Years in Croatia. Ther Apher Dial 2011; 15:587-92. [DOI: 10.1111/j.1744-9987.2011.00986.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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