Safety and tolerability of therapeutic plasma exchange in autoimmune neurological diseases — a retrospective single-centre analysis

Gala-Błądzińska, Agnieszka; Mazur, Katarzyna; Dębiec, Adam; Gargasz, Krzysztof; Bartosik-Psujek, Halina

doi:10.5603/pjnns.a2020.0045

Cited by 6 publications

(7 citation statements)

References 11 publications

(24 reference statements)

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“…TPE safety has been confirmed in the past [ 44 , 45 , 46 ]. In our analysis, adverse effects during TPE in COVID-19 were rather anecdotal, but we still need to bear in mind the limited number of observations and a considerable number of papers in which no information regarding side effects was provided.…”

Section: Discussionmentioning

confidence: 99%

What Is the Role of Therapeutic Plasma Exchange as an Adjunctive Treatment in Severe COVID-19: A Systematic Review

Krzych

Putowski

Czok

et al. 2021

Viruses

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Introduction: Since the COVID-19 pandemic outbreak, multiple promising treatment modalities have been tested, however, only several of them were proven to be effective. Therapeutic plasma exchange (TPE) has been recently discussed as a possible supportive treatment for severe cases. Methods: To investigate a possible role of TPE in severe COVID-19 we used a structured systematic search strategy to retrieve all relevant publications in the field. We screened in PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov for data published until the 4 June 2021. Results: We identified 18 papers, enrolling 384 patients, 220 of whom received TPE. The number of TPE sessions ranged from 1 to 9 and the type of replacement fluid varied markedly between studies (fresh frozen plasma or 5% albumin solution, or convalescent plasma). Biochemical improvement was observed in majority of studies as far as C-reactive protein (CRP), interleukin-6 (IL-6), ferritin, lactate dehydrogenase (LDH), D-dimer concentrations and lymphocyte count are concerned. The improvement at a laboratory level was associated with enhancement of respiratory function. Adverse effects were limited to five episodes of transient hypotension and one femoral artery puncture and thrombophlebitis. Conclusions: Although the effect of therapeutic plasma exchange on mortality remains unclarified, the procedure seems to improve various secondary end-points such as PaO2/FiO2 ratio or biomarkers of inflammation. Therapeutic plasma exchange appears to be a safe treatment modality in COVID-19 patients in terms of side effects.

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Section: Discussionmentioning

confidence: 99%

What Is the Role of Therapeutic Plasma Exchange as an Adjunctive Treatment in Severe COVID-19: A Systematic Review

Krzych

Putowski

Czok

et al. 2021

Viruses

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“…PE is an intrusive therapeutic procedure that entails a risk of consequences; nevertheless, in most cases, they are minor; in our study, their frequency was assessed to be 32.6% of all patients and 5.69% of all PE cycles, which is more compared to some other research [5]. Only one PE was associated with significant life‐threatening consequences in our patient (staphylococcus sepsis).…”

Section: Discussionmentioning

confidence: 50%

“…With this prerequisite, security risks are minimized [4]. Hypotension, technical problems with catheters, dyspnea, anemia, elevated leukocytosis and hypocalcaemia are main complications in PE treatment, according to recently published data from Poland [5]. Clinical Center of Montenegro-Clinic of Neurology is the only health institution at the tertiary level of neurological health care in Clinical Center of Montenegro.…”

Section: Introductionmentioning

confidence: 99%

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Plasma exchange in neurology patients—experience from single center in Montenegro

Roganovic,

Erakovic,

Radulovic

et al. 2023

Ther Apher Dial

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IntroductionPlasma exchange (PE) is widely used in many immune‐based neurological diseases. Our aim is to analyze characteristics of PE in neurological patients at the Clinical Center of Montenegro.MethodsOur study involved neurological patients treated with PE between January 2020 and April 2022.ResultsIn total, 246 PEs were performed in 43 patients. We divided patients into 4 groups according to indications. In 8/9 multiple sclerosis (MS) patients a decrease of Expanded Dysability Status Scale at least 0.5 was verified. In 14/20 Guillain Barre syndrome patients reduction of Hughes was observed. Four patients with myasthenia gravis (MG) were treated with PE. The most heterogeneous group (4) consisted of patients in whom the mechanism of disease development is assumed to be immune system dysregulation. Fourteen patients had any adverse event.ConclusionOur results show that PE is widely used and safe in the treatment of neurological diseases.

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“…We speculate that the autoimmune nature of polyneuropathy could justify immunomodulatory therapy use such as plasma exchange for those SSc patients who show neuropathic symptoms [38,39]. Thus more specific examinations of possible autoantibodies should be performed as the next stage of research.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of polyneuropathies among systemic sclerosis patients and impact on health-related quality of life

Ivanova

Žukovs

Možeitoviča

et al. 2023

Neurol Neurochir Pol.

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Introduction. Systemic sclerosis (SSc) is a chronic rheumatic disease that affects multiple organ systems, including the peripheral nervous system. However, studies into the involvement of polyneuropathies (PNP) have shown inconsistent results. The aim of this study was to determine the prevalence of small (SFN) and large (LFN) fibre neuropathy among SSc patients and the impact on health-related quality of life (HRQoL). Material and methods.The study enrolled 67 patients with diagnosed SSc. The severity of neuropathic symptoms was evaluated using shortened and revised total neuropathy scoring criteria. Nerve conduction studies were used for LFN, and quantitative sensory testing was used to evaluate SFN. Neuropathic pain was evaluated using a Douleur Neuropathique en 4 questionnaire, and the severity of anxiety symptoms was assessed using a Generalised Anxiety Disorder-7 scale. The Health Assessment Questionnaire-Disability Index was used to assess HRQoL. Previous data on antinuclear autoantibodies (ANA) test results was obtained. Statistical analysis was performed using SPSS software.Results. LFN was diagnosed in 47.8% (n = 32/67) and SFN in 40.3% (n = 27/67) of the subjects. ANA positivity was not associated with the presence of LFN/SFN. The severity of neuropathic pain had a significant correlation with anxiety symptoms (r = 0.61, p < 0.001), the severity of neuropathy symptoms (r = 0.51, p < 0.001) and HRQoL (r = 0.45, p < 0.001). The severity of neuropathy symptoms correlated with HRQoL (r = 0.39, p = 0.001).Conclusions. We demonstrated that PNP are found in almost all SSc patients. Also, SFN is as common as LFN. Additionally, we found that the severity of neuropathy symptoms and neuropathic pain are both associated with a worse HRQoL.

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Safety and tolerability of therapeutic plasma exchange in autoimmune neurological diseases — a retrospective single-centre analysis

Cited by 6 publications

References 11 publications

What Is the Role of Therapeutic Plasma Exchange as an Adjunctive Treatment in Severe COVID-19: A Systematic Review

What Is the Role of Therapeutic Plasma Exchange as an Adjunctive Treatment in Severe COVID-19: A Systematic Review

Plasma exchange in neurology patients—experience from single center in Montenegro

Prevalence of polyneuropathies among systemic sclerosis patients and impact on health-related quality of life

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