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[Plasma exchange in rheumatology. Technical problems, tolerance, indications].

A Prier, C Merlet, A C Koeger

    La Semaine Des Hopitaux : Organe Fonde Par L'Association D'Enseignement Medical Des Hopitaux De Paris
    |April 21, 1983
    PubMed
    Summary

    Plasma exchange is not recommended for common rheumatoid arthritis due to side effects and limited results. This therapy should be reserved for severe autoimmune conditions like malignant rheumatoid arthritis and hyperviscosity syndromes.

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    Diagnostic value of ferritin and glycosylated ferritin in adult onset Still's disease.

    The Journal of rheumatology·2001

    Area of Science:

    • Rheumatology
    • Immunology
    • Therapeutic Apheresis

    Context:

    • Plasma exchange has been utilized for severe rheumatoid arthritis since 1979.
    • Recent literature and clinical experience provide new insights into its efficacy.
    • The established role of plasma exchange in rheumatology warrants re-evaluation.

    Purpose:

    • To evaluate the current role of plasma exchange in managing rheumatoid arthritis.
    • To determine the appropriate indications for plasma exchange therapy in autoimmune and hematologic disorders.

    Summary:

    • Plasma exchange is not advocated for the general treatment of rheumatoid arthritis.
    • Significant side effects, technical complexity, and transient benefits limit its use.
    • Current evidence suggests restricting plasma exchange to severe, refractory cases, including malignant rheumatoid arthritis, lupus, scleroderma exacerbations, and hyperviscosity syndromes.

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    Impact:

    • This review refines therapeutic guidelines for plasma exchange in rheumatology.
    • It emphasizes a more selective approach to apheresis, prioritizing patient safety and resource allocation.
    • Clinical practice may shift towards reserving plasma exchange for specific, severe autoimmune and hematologic conditions.