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Plasma-exchange in chronic peripheral neurological disorders
1Servizio Immunotrasfusionale, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy.
The International Journal of Artificial Organs
|March 31, 1999
Summary
Therapeutic plasma exchange (TPE) showed symptomatic improvement in 58% of patients with chronic neurological disorders. Adjunctive therapies like IVIg and prolonged alpha-IFN may enhance TPE efficacy for specific patient groups.
Area of Science:
- Neurology
- Immunology
- Hematology
Background:
- Chronic peripheral neurological disorders present complex treatment challenges.
- Therapeutic plasma exchange (TPE) is utilized, but its efficacy and optimal protocols require further investigation.
Purpose of the Study:
- To evaluate the efficacy of a specific therapeutic plasma exchange (TPE) protocol for chronic peripheral neurological disorders.
- To identify potential adjunctive therapies and modifications to improve TPE outcomes.
Main Methods:
- Nineteen patients with chronic peripheral neurological disorders received TPE.
- Patients were assessed after an initial 5 TPE sessions; responders continued with a modified TPE schedule combined with chemotherapy.
- Intravenous immunoglobulins (IVIg) were administered post-TPE in one case; HCV-positive patients received alpha-interferon (alpha-IFN) for 6 months prior to TPE.
Main Results:
- Eleven patients (58%) experienced symptomatic improvement.
- Two patients (1.5%) discontinued TPE due to adverse effects.
- Six patients (31.5%) did not respond to the TPE therapy.
Conclusions:
- TPE can be effective for select patients with chronic peripheral neurological disorders.
- Administering IVIg post-TPE may enhance treatment benefits.
- For HCV-positive patients with cryoglobulinemia, a minimum of one year of alpha-IFN therapy before TPE is recommended.