[Effectiveness of plasma exchange therapy in patients with rheumatoid arthritis and systemic manifestations]

For the advantage of the therapeutic plasma exchange in the active rheumatoid arthritis there exist at present contradictory opinions. Three patients with rheumatoid arthritis and systemic manifestation as well as high activity of the disease, in whom the conventional therapy with antirheumatic drugs showed only little effectiveness and which was stopped due to severe side effects, respectively, underwent 6 plasma exchange treatments within 14 days. The subjective condition as well as standardized clinical and laboratory-chemical activity parameters quickly ameliorated. A positive therapeutic effect was to be proved still after 6 to 12 months. In 2 patients a proposed synovectomy could be renounced. The reasonable indication for the plasma exchange will be given when there is an acute immunological reaction which can be shortened by a rapid reduction of pathogenic protein fractions before irreversible morphological injuries occur.