Clinical experience of double filtration plasmapheresis for drug refractory neurological diseases

The effect of therapeutic double filtration plasmapheresis (DFPP) was clinically investigated for drug refractory neurological disorders. DFPP therapy was performed 181 times for 10 patients who were treated with medical therapy of steroid or immunosuppressive drugs without any improvement of their symptoms. After the induction of DFPP therapy the neuromuscular disturbances were soon ameliorated in 9 cases of them. After DFPP, serum levels of IgG, IgA or IgM were decreased as follows: IgG 0.53 +/- 0.16; IgA 0.60 +/- 0.11; IgM 0.59 +/- 0.09 (M +/- SD). After the DFPP therapy there was no relapse in improved 9 cases. But we could not regard the immunologic markers as the index of efficacy of DFPP. Because serum levels of IgG, IgA or IgM showed a tendency to decrease by using drugs, when we didn't observe any improvement of symptoms. These results suggest that DFPP is a beneficial therapy for neurological diseases who had no effect with drug therapy, however, serum concentrations of the immunologic markers were not necessarily correlated to the severity.