[Plasma exchange therapy in children and adolescents with systemic lupus erythematosus (SLE)]

Five children (11.5-17.5 years of age) with severe systemic lupus erythematosus (SLE) were treated with plasma exchange. Three children suffered from renal failure and hypertension, one adolescent girl from gastrointestinal and arthritic pains with fever, and one patient from generalized paresis. All patients had excessive serological signs of disease activity. Forty-five sessions of plasma exchange were performed without serious complications. Four children showed improvement of SLE after initiation of plasma exchange in combination with immunosuppressive therapy in two of them renal replacement therapy could be stopped. In the 2 patients with non-renal SLE-complications a dramatic rapid improvement of the symptoms was observed. One girl succumbed to severe hypertension with cerebral bleeding and fungal sepsis after pulsE therapy a few days after start of plasma exchange. Plasma exchange should be started before observation of life threatening complications of SLE. Further information is needed about indication, frequency and duration of plasma exchange in children with SLE.