Clinical Usefulness of Selective Plasma Exchange for Treating Pediatric Autoimmune Neurological Diseases.

Abstract

Introduction: Selective plasma exchange (SePE) using the Evacure Plus EC-4A10D selective membrane separator is a useful therapeutic option for removing immunoglobulin G (IgG) in autoimmune diseases while retaining coagulation factors, including fibrinogen. This study aimed to clarify the clinical usefulness of SePE in pediatric autoimmune neurological disorders.

Methods: We reported five pediatric patients with pediatric autoimmune neurological disorders successfully treated with SePE. We analyzed the removal rates of IgG and fibrinogen in a total of 29 SePE sessions and 3 conventional plasma exchange (PE) sessions performed on five pediatric patients.

Results: Clinical symptoms improved in all patients without coagulation factor supplementation, and no severe adverse events of SePE/PE were observed. The mean IgG removal rates were similar for SePE and PE, at 55.5% and 61.8%, respectively. In contrast, the mean fibrinogen removal rate was lower for SePE than for PE, at 17.9% and 61.3%, respectively.

Conclusions: SePE might be effective for pediatric autoimmune neurological disorders.