Therapeutic Plasma Exchange as a Treatment for Autoimmune Neurological Disease.

IF 1.7 Q4 IMMUNOLOGY

Autoimmune Diseases Pub Date : 2020-07-31 eCollection Date: 2020-01-01 DOI:10.1155/2020/3484659

Ivana Nieto-Aristizábal, Álvaro J Vivas, Pablo Ruiz-Montaño, Cristian C Aragón, Iván Posso-Osorio, Jairo Quiñones, Julián Alejandro Rivillas, Gabriel J Tobón

{"title":"Therapeutic Plasma Exchange as a Treatment for Autoimmune Neurological Disease.","authors":"Ivana Nieto-Aristizábal, Álvaro J Vivas, Pablo Ruiz-Montaño, Cristian C Aragón, Iván Posso-Osorio, Jairo Quiñones, Julián Alejandro Rivillas, Gabriel J Tobón","doi":"10.1155/2020/3484659","DOIUrl":null,"url":null,"abstract":"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.","PeriodicalId":46314,"journal":{"name":"Autoimmune Diseases","volume":"2020 ","pages":"3484659"},"PeriodicalIF":1.7000,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3484659","citationCount":"8","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Autoimmune Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2020/3484659","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 8

Abstract

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.

Abstract Image

查看原文本刊更多论文

血浆置换治疗自身免疫性神经系统疾病

治疗性血浆置换(TPE)通常用于治疗某些自身免疫性神经疾病(ANDs)，其主要目的是去除致病性自身抗体。我们的目的是描述临床概况和使用TPE的经验，在我们的机构与患者的ANDs。方法:这是一项观察性回顾性研究，包括2011年至2018年期间诊断为ANDs并接受TPE的患者的医疗记录。评估TPE的特征，如循环次数、替代溶液类型和不良反应。采用改良Rankin量表(mRS)评价治疗后的临床疗效。结果:187例患者被诊断为:重症肌无力(MG)， n = 70 (37%);吉兰-巴利综合征(GBS)， n = 53(28.3%)，视神经脊髓炎(NMOSD)， n = 35 (18.7%);慢性炎性脱髓鞘性多神经病变(CIDP)， n = 23 (12.2%);自身免疫性脑炎(AE)， n = 6(3.2%)。使用最多的替代溶液类型是白蛋白(n = 131, 70%)和琥珀酰明胶(n = 45, 24%)。所有患者接受中位数为5个周期(IQR 5-5)。低血压和电解质紊乱是主要的并发症。TPE后mRS评分改善者99例(52.9%)，除CIDP外，入院评分与TPE后比较差异均有统计学意义(p < 0.05)。结论:TPE具有足够的安全性，治疗后患者功能的改善反映了其有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Autoimmune Diseases IMMUNOLOGY-

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

17 weeks