Vasculitis secondary to staphylococcal Protein A immunoadsorption (Prosorba column) treatment in rheumatoid arthritis

Deodhar, Atul; Allen, Elyse M.; Daoud, K F; Wahba, Ihab

doi:10.1053/sarh.2002.33723

Cited by 21 publications

(17 citation statements)

References 8 publications

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“…A temporary arthritis exacerbation was only seen when adsorptions were administered biweekly. Furthermore, no side effects, suprainfections, hemolysis, or secondary vasculitis, were noticed as previously described for other columns [16,17].…”

Section: Discussionsupporting

confidence: 68%

Immunoadsorption with tryptophan columns: A therapeutic option for the treatment of rheumatoid arthritis with septic complications

Thomaidis

Schorn²,

Flaig³

et al. 2009

J of Clinical Apheresis

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Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting multiple organs and tissues. Although there is a wide range of therapeutic applications, the coexistence of severe side effects and contraindications outlines the necessity of new therapeutic options in the treatment of severe RA. We report on the case of a 71-year-old patient with successful treatment of a complicated RA with tryptophan immunoadsorption combined with low-dose steroids. Bacterial spondylitis developed in this patient during long-term treatment with infliximab and methotrexate. Weekly immunoadsorption sessions with tryptophan columns resulted in continuous suppression of RA activity over a period of more than 5 months, as indicated by laboratory findings, the disease activity score, and the visual analog scale. This is the first report of successful treatment of a refractory and complicated RA using tryptophan immunoadsorption columns. In conclusion, immunoadsorption is a safe and effective therapeutic alternative, which should be considered to bridge infectious complications in patients with severe RA.

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Section: Discussionsupporting

confidence: 68%

Immunoadsorption with tryptophan columns: A therapeutic option for the treatment of rheumatoid arthritis with septic complications

Thomaidis

Schorn²,

Flaig³

et al. 2009

J of Clinical Apheresis

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“…Protein A, a component of Staphylococcus aureus cellular membrane, showing a high affinity to IgG, strongly binds the immunoglobulins IgG1, IgG2, IgG4 slightly less IgG3, while IA of immunoglobulins IgGM and IgGA does not exceed 30% of the output value. The adverse effect of IA might be leukocytostatis, which leads to generalized vasculitis with or without glomerulonephritis [17,18] . In IA as adsorbents chemical compounds, like tryptophan or polyacrylate, which lower the concentration of LDL lipoprotein, may be also used.…”

Section: New Options Of Apheresis In Renal Diseases: How?mentioning

confidence: 99%

New Options of Apheresis in Renal Diseases: How and When?

Korsak¹,

Wańkowicz²

2015

Blood Purif

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The 100-year anniversary of the first experimental apheresis performed by John Abel on uremic dogs in 1914 provides the opportunity for discussion on the current state of classic apheresis as well as technological progress and clinical experiences with its new options presented in the world literature in the last 15 years, such as the following: double filtration, plasma adsorption and immunoadsorption, leuko- and cytapheresis and low-density lipoprotein apheresis. In our review, we highlight the potential limitations for further development of those highly promising techniques, such as the following: the lack of multicenter, controlled clinical studies; insufficient knowledge of the mechanisms of those techniques and last but not least, the restricted access to apheresis, caused both by high expenditure and organizational negligence, even in highly developed countries. Special attention was paid to the most recent recommendations by the American Society of Apheresis in primary and secondary renal diseases, which are the subject of our professional interest.

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“…It is employed for the reduction of Ig (mainly IgG3) and immunocomplexes in the treatment of various diseases such as chronic dilated myocardiopathy and myasthenia gravis. However, there have been reports that apheresis with staphylococcal protein A has led to secondary vasculitis due to the appearance of antistaphylococcal protein antibodies [44]. Currently, there are also anti‐sheep Ig sepharose‐bound Therasorb columns that are used in dilated myocardioapthy and for the removal of LDL‐cholesterol.…”

Section: Surface Cell Receptor Downmodulationmentioning

confidence: 99%

Therapeutic Apheresis procedures: mechanisms of action and Immunomodulatory effects

Muñoz

2008

ISBT Science Series

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Vasculitis secondary to staphylococcal Protein A immunoadsorption (Prosorba column) treatment in rheumatoid arthritis

Cited by 21 publications

References 8 publications

Immunoadsorption with tryptophan columns: A therapeutic option for the treatment of rheumatoid arthritis with septic complications

Immunoadsorption with tryptophan columns: A therapeutic option for the treatment of rheumatoid arthritis with septic complications

New Options of Apheresis in Renal Diseases: How and When?

Therapeutic Apheresis procedures: mechanisms of action and Immunomodulatory effects

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