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Plasma Exchange and Immunoadsorption in Pediatric Inflammatory Optic Neuropathy Resistant to Corticosteroid Therapy:
Coralie Jacquet1, Arnaud Garnier2, Emmanuel Cheuret1
1Service de Neurologie Pédiatrique, Hôpital des Enfants, TSA, Toulouse, France.
Insights
Steroids are standard for pediatric optic neuritis, but some children resist treatment. Plasma exchange and immunoadsorption offer effective alternatives for steroid-resistant cases in children.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Immunology
Background:
- Steroids are the primary treatment for pediatric optic neuritis (ON).
- Current steroid treatment protocols for pediatric ON are not standardized.
- Some children exhibit resistance to conventional steroid therapy.
Observation:
- This study reports on four pediatric patients with optic neuritis (ON) who did not respond to steroid treatment.
- Two patients were treated with plasma exchange (PE).
- Two patients were treated with immunoadsorption (IA).
Findings:
- Both plasma exchange (PE) and immunoadsorption (IA) were utilized as alternative therapies for steroid-resistant pediatric optic neuritis (ON).
- Treatment protocols and observed side effects for PE and IA in these pediatric cases are described.
- These findings suggest PE and IA as viable options for managing refractory ON in children.
Implications:
- Plasma exchange (PE) and immunoadsorption (IA) show promise as effective treatments for pediatric optic neuritis (ON) when steroids fail.
- Further research is warranted to establish standardized protocols for PE and IA in pediatric ON management.
- These alternative therapies could improve outcomes for children with difficult-to-treat optic neuritis.
Abstract:
Steroids as a foremost therapy are widely used in pediatric optic neuritis (ON). Yet, this treatment is not standardized to date. Some children show a resistance to the classic treatment by steroids. Although plasma exchange (PE) and immunoadsorption (IA) techniques are increasingly being adopted and lead to good results in resistant cases in adult patients, very few studies have shown interest in treating ON when steroids have failed. In this study, we report four observations of children, two of whom are treated by PE and two by IA techniques, describing the treatment protocols together with the side effects observed.
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