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[Immunoglobulin deficiency after repeated plasmapheresis].
C Stebler1, A Tichelli, H Dazzi
1Departement Innere Medizin, Kantonsspital Basel.
Schweizerische Medizinische Wochenschrift
|February 2, 1991
Summary
Plasmapheresis for Guillain-Barré syndrome can deplete immunoglobulins. Using immunoglobulin-rich plasma substitutes helps maintain crucial immunoglobulin levels, preventing potential complications like infections.
Area of Science:
- Neurology
- Immunology
- Hematology
Context:
- Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- Plasmapheresis is a treatment that removes plasma from the blood.
- Standard plasma substitutes may lead to a significant reduction in globulins and immunoglobulins.
Purpose:
- To investigate the impact of different plasma substitutes on globulin and immunoglobulin levels during plasmapheresis in GBS patients.
- To compare the efficacy of PPL versus immunoglobulin-rich plasma substitutes (IRP).
Summary:
- Plasmapheresis using PPL resulted in a significant drop in globulins and immunoglobulins, with only partial recovery between sessions.
- Immunoglobulin levels decreased substantially, reaching critically low levels in some cases.
- The use of an immunoglobulin-rich plasma substitute (IRP) effectively maintained normal globulin levels and higher immunoglobulin concentrations.
Impact:
- Therapeutic plasmapheresis with PPL may increase the risk of infection due to low immunoglobulin levels, as suggested by a case of gram-negative septicaemia.
- Using immunoglobulin-rich plasma substitutes during plasmapheresis is recommended to maintain physiological immunoglobulin concentrations and potentially reduce complications in GBS patients.