An approach to immunologic reactions associated with plasma exchange
1Department of Medicine, University of Connecticut Health Center, Farmington 06030.
The Journal of Allergy and Clinical Immunology
|July 1, 1992
Summary
Anaphylactic-type reactions during pulmonary embolism (PE) treatment require further study. Strategies include addressing equipment issues, testing for immunogens, and considering premedication to manage risks.
Area of Science:
- Immunology
- Medical Devices
Background:
- Anaphylactic-type events are frequently observed during pulmonary embolism (PE) treatment.
- The underlying mechanisms of these immunologically mediated reactions remain poorly understood.
Observation:
- Potential causes include technique or equipment-related factors, such as biocompatibility of membranes and residual ethylene oxide.
- Reactions may also be linked to specific immunogens or the infusion of essential blood products.
Findings:
- Addressing equipment issues, like using biocompatible membranes and improved rinsing, can mitigate reactions.
- Investigating specific immunogens through in vivo or in vitro testing is recommended.
- Premedication regimens may be effective when blood product infusion is the suspected cause.
Implications:
- Management should prioritize preventing compromised oxygenation and perfusion in mother and fetus.
- Balancing treatment risks and benefits is crucial, focusing on symptom management and avoiding adverse drug effects.
- Further research into the pathogenesis of anaphylaxis in PE is warranted.
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