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Related Experiment Videos

Coagulation abnormalities in serial double-filtration plasmapheresis.

J H Yeh1, H C Chiu

  • 1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Journal of Clinical Apheresis
|December 18, 2001
PubMed
Summary

Serial double filtration plasmapheresis (DFP) significantly reduces fibrinogen levels in myasthenia gravis patients. Despite hemostatic alterations, DFP demonstrates safety with a low incidence of bleeding complications.

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Area of Science:

  • Hematology
  • Neurology
  • Nephrology

Background:

  • Plasma exchange therapies can impact the hemostatic system.
  • The specific effects of serial double filtration plasmapheresis (DFP) on hemostasis require further elucidation.

Purpose of the Study:

  • To characterize the hemostatic effects of a 10-day course of serial DFP in myasthenia gravis patients.
  • To assess the safety and bleeding complications associated with intensive DFP treatment.

Main Methods:

  • Thirty-two myasthenia gravis patients underwent five consecutive DFP sessions over 10 days.
  • Hemostatic parameters (platelet count, PT, PTT) and serum analytes (albumin, globulin, cholesterol, fibrinogen) were measured pre- and post-treatment.
  • Patients were stratified into mild hypofibrinogenemia (MH) and severe hypofibrinogenemia (SH) groups based on post-DFP fibrinogen levels.

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Main Results:

  • DFP treatment reduced fibrinogen levels below 70 mg/dl in 44% of patients.
  • The SH group exhibited a higher incidence of prolonged PT/PTT and greater reductions in globulin and cholesterol.
  • Minor oozing at catheter sites occurred in 23% of patients, with no significant difference in bleeding complications between MH and SH groups.

Conclusions:

  • Intensive serial DFP significantly lowers fibrinogen levels and affects other hemostatic parameters.
  • Despite these changes, DFP treatment is associated with a low incidence of clinically significant bleeding, confirming its safety profile in myasthenia gravis patients.