Plasmaferese em neurologia análise crítica da indicação e protocolos

Jc, Seggia; Abreu, Paulo César Oliveira Vergne de

doi:10.1590/s0004-282x1992000300011

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…In our unit, a cost benefit analysis would favor a somewhat simplified procedure comprised of 5 sessions of plasmapheresis (one session a day on alternate days) 16 with a capillary type of plasma separator, anticoagulants and a double light catheter in a deep vein (e.g., femoral), and the use of several reposition solutions (for example, Ringer-albumin, Ringer-plasma, serum-albumin, serum-plasma).…”

Section: Commentsmentioning

confidence: 99%

Plasmapheresis as preparatory method for thymectomy in myasthenia gravis

Seggia¹,

Abreu²,

Takatani³

1995

Arq. Neuro-Psiquiatr.

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SUMMARY -To study the effects of plasmapheresis in preparation for thymectomy, two groups of 40 patients were selected from a sample of 286 patients with myasthenia gravis examined by the first author Group 1 included patients (15 male and 25 female; age range 8-64 yrs) who underwent thymectomy without previous plasmapheresis, whereas patients in group 2 (17 male and 23 female; age range 11-61 yrs) were thymectomized after plasmapheresis. We required patients to have a minimum follow-up period of 12 months to be included in the study. A clinical evaluation protocol composed of 76 items was developed for the study. We found significant improvement in respiratory function and muscular strength in patients thymetomized after plasmapheresis. Furthermore, the combined treatment reduced cost and length of hospital stay. Therefore, we conclude that plasmapheresis should be considered as a coadjuvant to thymectomy in the treatment of myasthenia gravis.KEY WORDS: myasthenia gravis, thymectomy, plasmapheresis. Plasmaferese como método preparatório de timectomia em miastenia graveRESUMO -No intuito de estudar as repercussões de um curso de plasmaferese como método preparatório para a timectomia, tomamos duas amostras de 40 pacientes selecionados de um universo de 286 casos de miastenia gravis, em que a investigação clínica, eletrofisiológica, laboratorial, o seguimento e o protocolo foram completamente realizados. Consideramos como grupo 1 aquele em que a timectomia foi realizada sem preparação pre-operatória e grupo 2 aquele em que a plasmaferese foi executada como coadjuvante a timectomia. O grupo 1 era composto de 15 pacientes do sexo masculino e 25 do feminino; a idade variou de 8 a 64 anos com mediana de 30 anos. No segundo grupo, 17 eram masculinos e 23 femininos; a idade variou de 11 a 61 anos com mediana de 33 anos. Foi preenchida ficha de avaliação clínica sequencial de 76 itens e traçamos um curso de plasmaferese de 5 sessões seguido da timectomia, mantendo a mesma técnica operatória, realizada pela mesma equipe cirúrgica, tentando assim minimizar as distorções na análise e manuseio destes pacientes. Obtivemos melhora clínica, da insuficiência respiratória, da força muscular e reduzimos também o custo da internação quando comparada aos pacientes em que a cirurgia foi realizada sem a plasmaferese e em alguns casos em que realizamos preparação com corticosteróides. Acreditamos que a plasmaferese deva ser considerada como método coadjuvante no tratamento cirúrgico desta grave afecção. PALAVRAS-CHAVE: miastenia gravis, timectomia, plasmaferese.Myasthenia gravis (MG) is a disease of the neuromuscular junction characterized by weakness and abnormal fatigue in the skeletal muscles. It was first described by Thomas Willis in 1672.However, a more precise clinical account of this disorder was offered by Campbell and Bramwell in 1900 4 . In 1901, Oppenheim hypothesized that MG was a disease of the neuromuscular junction by analogy with symptoms of curare poisoning 21 . Several clinical aspects suggest that the basic defect ...

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Section: Commentsmentioning

confidence: 99%

Plasmapheresis as preparatory method for thymectomy in myasthenia gravis

Seggia¹,

Abreu²,

Takatani³

1995

Arq. Neuro-Psiquiatr.

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Muscle Diseases

2008

Tachdjian's Pediatric Orthopaedics

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Familial amyloid polyneuropathy with genetic anticipation associated to a gly47glu transthyretin variant in an Italian kindred

Pelo

Prato²,

Ciaccheri

et al. 2002

Amyloid

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The most frequent localization of amyloid in transthyretin (TTR) mutations is in the peripheral nerve, causing familial amyloidpolyneuropathy (FAP). It is generally accompanied by involvement of other organs such as the myocardium and kidney. To date, over 70 TTR point mutations have been reported in literature, with different phenotypes depending on the location of the mutation in the TTR gene. This paper deals with a point mutation in exon 2 position 47 of the TTR gene, encoding the substitution of glycine with glutamate. The mutation was found in an Italian family with 5 patients over 3 generations. The phenotype was characterised by peripheral neuropathy and autonomic dysfunction, associated in some patients with cardiomyopathy and renal involvement. The symptoms were very severe and the patients did not survive long, thus suggesting the aggressive nature of the pathological process. Moreover, in the succeeding generations of this family, there was genetic anticipation in the age of onset of the disease.

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Plasmaferese em neurologia análise crítica da indicação e protocolos

Cited by 3 publications

References 18 publications

Plasmapheresis as preparatory method for thymectomy in myasthenia gravis

Plasmapheresis as preparatory method for thymectomy in myasthenia gravis

Muscle Diseases

Familial amyloid polyneuropathy with genetic anticipation associated to a gly47glu transthyretin variant in an Italian kindred

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