Clinical Usefulness of Selective Plasma Exchange for Treating Pediatric Autoimmune Neurological Diseases

Selective plasma exchange (SePE) using the Evacure Plus EC-4A10D selective membrane separator is a useful therapeutic option for removing immunoglobulin G (IgG) in autoimmune diseases while retaining coagulation factors, including fibrinogen. This study aimed to clarify the clinical usefulness of SePE in pediatric autoimmune neurological disorders.

We reported five pediatric patients with pediatric autoimmune neurological disorders successfully treated with SePE. We analyzed the removal rates of IgG and fibrinogen in a total of 29 SePE sessions and 3 conventional plasma exchange (PE) sessions performed on five pediatric patients.

Clinical symptoms improved in all patients without coagulation factor supplementation, and no severe adverse events of SePE/PE were observed. The mean IgG removal rates were similar for SePE and PE, at 55.5% and 61.8%, respectively. In contrast, the mean fibrinogen removal rate was lower for SePE than for PE, at 17.9% and 61.3%, respectively.

SePE might be effective for pediatric autoimmune neurological disorders.