Plasmapheresis and Paraproteinemia: Cryoprotein‐Induced Diseases, Monoclonal Gammopathy, Waldenström's Macroglobulinemia, Hyperviscosity Syndrome, Multiple Myeloma, Light Chain Disease, and Amyloidosis

Siami, Ghodrat A.; Siami, Flora S.

doi:10.1046/j.1526-0968.1999.00146.x

Cited by 45 publications

(27 citation statements)

References 89 publications

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“…Anecdotally, TPE has been used in combination with hemodialysis in two patients with AL amyloidosis and renal failure, one of whom had amyloid arthropathy. However, no positive data exist, supporting the use of TPE for neuropathy or other complications associated with AL, DRA, or AA amyloidosis [6][7][8].…”

Section: Amyloidosis Systemicmentioning

confidence: 99%

Category IV indications for therapeutic apheresis—ASFA fourth special issue

Shaz

Linenberger

Bandarenko

et al. 2007

J of Clinical Apheresis

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The American Society for Apheresis (ASFA) Committee on Clinical Applications systematically and critically reviews published information on the use of therapeutic apheresis in clinical practice. On the basis of this review, selected diseases are assigned one of five categories (category I, II, III, IV, and P). The diseases, which were classified as category IV indications, and the rationale for such assignment are reviewed in this article. The diseases assigned to category I, II, III, and newly created category P are discussed in a separate article in this issue.

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Section: Amyloidosis Systemicmentioning

confidence: 99%

Category IV indications for therapeutic apheresis—ASFA fourth special issue

Shaz

Linenberger

Bandarenko

et al. 2007

J of Clinical Apheresis

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“…3 Treatment for primary CF with reported success includes use of fibrinolytics (eg, streptokinase), 3,[16][17][18][19][20] immunomodulators (eg, glucocorticoids in combination with azathioprine or chlorambucil, and plasmapheresis), 5,[21][22][23][24] and anticoagulants (eg, such as heparin and warfarin). 14,25 Aspirin and colchicine have been shown to be ineffective.…”

Section: Discussionmentioning

confidence: 99%

“…5 Treatment for secondary CF is directed by screening and evaluation for possible underlying infection, malignancy or inflammatory disease, and specific treatment of the underlying disease. Studies have shown that glucocorticoids, cytotoxic therapy (such as cyclophosphamide), and plasmapheresis may be effective for treating patients with underlying connective tissue diseases 24,26,27 and may be an effective therapy in severe cases. 3 Antimicrobial therapy may be an effective strategy for patients with CF secondary to infection.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Chen

Sreenivasan²,

Shojania³

et al. 2015

Exp Clin Transplant

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Cryofibrinogenemia is a rare disorder in which plasma, not serum, forms a cryoprecipitate. Patients with cryofibrinogenemia may be asymptomatic, or they may have painful ulcers, purpura, livedo reticularis, Raynaud phenomenon, perniosis of the extremities, thrombosis, and arthralgia. Cryofibrinogenemia may be primary or secondary to an underlying disorder such as connective tissue disease, malignancy, infection, drugs, or thromboembolic disease.Here, we present a 41-year-old woman with a pancreatic neuroendocrine tumor who underwent a Whipple procedure in 2003 followed by 2 liver transplants for hepatic metastases. Three years posttransplant, we discovered a biopsy-proven metastatic lesion in her femur. Five years posttransplant, she developed acute, severe pain in both feet, and was found to have cryofibrinogenemia despite immunosuppression posttransplant. Testing for connective tissue diseases and hematologic malignancy were negative. She was treated with high-dose prednisone, which completely resolved her symptoms. We also conducted a review of the literature via a PubMed search to summarize the association of cryofibrinogenemia with malignancy and treating cryofibrinogenemia with corticosteroids.Our study is the first reported case of cryofibrinogenemia that developed secondary to a neuroendocrine tumor posttransplant. Our report suggests that cryofibrinogenemia may occur despite immunosuppression adequate to prevent graft rejection, and that high-dose corticosteroids are an effective treatment for posttransplant cryofibrinogenemia.

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“…Plasmapheresis is performed together with administration of corticosteroids and immunosuppressive drugs in order to prevent production of abnormal protein or to treat primary disease. But it is impractical for long-term treatment (Langford CA, 2010;Siami GA & Siami FS, 1999). Rituximab, a chimeric monoclonal anti-CD20 antibody, is suitable as a rescue therapy in resistant cryoglobulinemia associated with HCV (Ahmed MS & Wong CF, 2007).…”

Section: Cryoglobulinemic Vasculitismentioning

confidence: 99%