Clinical Improvement with Therapeutic Plasma Exchange in Neuroimmunological Children: A Single Center Experience

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2023-07-24 DOI:10.5812/ijp-137105

A. Nikkhah, M. Nasehi, N. Momtazmanesh, Kourosh Etemad, Somaye Hajatnia

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引用次数: 0

Abstract

Background: Neuroimmunological diseases in children encompass a range of disorders that lead to neurological complications in patients due to immune responses and systemic circulating antibodies. Limited research has been conducted on therapeutic plasma exchange’s efficacy and potential side effects in children with neuroimmunological diseases. Objectives: This study aimed to investigate this procedure’s effectiveness and potential side effects in children afflicted by these diseases. Methods: This cross-sectional study examined a cohort of 18 children with neuroimmunological diseases who were admitted to the neurology department of Mofid Hospital over one year from March 2021 and underwent therapeutic plasma exchange. Results: The study included 18 patients, with an equal distribution of 9 females and 9 males. A total of 121 procedures were performed across 6 different disease groups: Multiple Sclerosis (22%, n = 4), Autoimmune Encephalitis (22%, n = 4), Neuromyelitis Optica Spectrum Disorder (22%, n = 4), Guillain-Barré syndrome (22%, n = 4), Acute Disseminated Encephalomyelitis (6%, n = 1), and Optic Neuritis (6%, n = 1). Following the plasma exchange, 17 patients (95%) showed immediate clinical improvement, while one patient diagnosed with optic neuritis did not respond to the treatment. During the follow-up period, 14 patients (78%) demonstrated significant improvement, one patient (6%) showed moderate improvement, and two patients (11%) exhibited mild improvement compared to their pre-plasmapheresis condition. Laboratory examinations revealed that only one patient experienced thrombocytopenia, which resolved without requiring treatment. No complications were observed during the follow-up visits for any of the patients. Conclusions: Plasma exchange is a safe procedure for children with neuroimmunological diseases and yields favorable clinical responses.

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治疗性血浆置换对神经免疫儿童的临床改善:单中心经验

背景:儿童神经免疫学疾病包括一系列疾病，由于免疫反应和全身循环抗体导致患者出现神经系统并发症。关于治疗性血浆置换治疗儿童神经免疫疾病的疗效和潜在副作用的研究有限。目的:本研究旨在探讨该手术对患有这些疾病的儿童的有效性和潜在副作用。方法:本横断面研究纳入了自2021年3月起在Mofid医院神经内科住院一年以上并接受治疗性血浆置换的18例神经免疫学疾病患儿。结果:纳入18例患者，男女各9例，平均分布。在6个不同的疾病组中共进行了121例手术:多发性硬化症(22%，n = 4)、自身免疫性脑炎(22%，n = 4)、视神经脊髓炎视谱障碍(22%，n = 4)、格林-巴利综合征(22%，n = 4)、急性播散性脑脊髓炎(6%，n = 1)和视神经炎(6%，n = 1)。血浆置换后，17例患者(95%)立即出现临床改善，而1例诊断为视神经炎的患者对治疗无反应。在随访期间，14例患者(78%)表现出显著改善，1例患者(6%)表现出中度改善，2例患者(11%)表现出轻度改善。实验室检查显示，只有一名患者出现血小板减少症，无需治疗即可解决。随访期间未发现任何并发症。结论:血浆置换治疗儿童神经免疫性疾病是一种安全的治疗方法，并能产生良好的临床反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.