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Trace elements and plasmapheresis.

S Hosokawa1, A Oyamaguchi, O Yoshida

  • 1Utano National Hospital, Kyoto, Japan.

The International Journal of Artificial Organs
|April 1, 1991
PubMed
Summary
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Plasmapheresis (PP) treatment significantly increases serum aluminum (Al) levels while decreasing zinc (Zn), copper (Cu), and iron (Fe). Removing Al during PP is crucial to prevent aluminum intoxication in patients.

Area of Science:

  • Biochemistry
  • Clinical Chemistry
  • Toxicology

Background:

  • Plasmapheresis (PP) is a medical procedure to remove plasma components.
  • Patients with rheumatoid arthritis, myasthenia gravis, and multiple sclerosis undergo PP treatment.
  • The impact of PP on serum trace element levels, particularly aluminum, is not well understood.

Purpose of the Study:

  • To investigate the relationship between serum aluminum (Al), zinc (Zn), copper (Cu), and iron (Fe) levels and plasmapheresis (PP) treatment.
  • To assess the changes in these trace elements before and after PP sessions.
  • To determine the necessity of aluminum removal during PP to prevent potential toxicity.

Main Methods:

  • Serum Al, Zn, Cu, and Fe levels were measured in 15 patients (3 rheumatoid arthritis, 6 myasthenia gravis, 6 multiple sclerosis) before and after PP.

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  • Plasma was processed using a two-step filtration method.
  • Three liters of plasma were treated per PP session, removing approximately 20% of total protein and 6% of albumin.

    • Main Results:

    • Serum Al levels significantly increased post-PP (1.1 to 2.8 µg/dL, p<0.01) and remained elevated two days after treatment cessation (3.6 µg/dL).
    • Serum Zn, Cu, and Fe levels significantly decreased post-PP (Zn: 86.2 to 58.4 µg/dL, Cu: 126 to 104 µg/dL, Fe: 108 to 82 µg/dL, p<0.01).
    • Total protein and albumin levels showed no significant changes post-PP.

    Conclusions:

    • Plasmapheresis treatment leads to a significant accumulation of aluminum in the serum.
    • Concurrent depletion of essential trace elements (Zn, Cu, Fe) occurs during PP.
    • Proactive removal of aluminum during plasmapheresis is essential to mitigate the risk of aluminum intoxication in treated patients.