Plasma-exchange in neurological diseases.

Area of Science:

• Neurology
• Immunology
• Therapeutic Apheresis

Background:

• Neurological diseases encompass a range of debilitating conditions affecting the nervous system.
• Plasma-exchange therapy is an apheresis technique used to remove harmful substances from the blood.
• Various neurological conditions have been treated with plasma-exchange therapy with varying success.

Purpose of the Study:

• To summarize the experience with plasma-exchange therapy for various neurological diseases at Saronno hospital.
• To evaluate the efficacy of plasma-exchange therapy, particularly when combined with other treatments.
• To assess the impact of this therapeutic approach on the natural course of neurological diseases.

Main Methods:

• Plasma-exchange therapy utilizing discontinuous flow centrifugation, membrane plasma separation, and cascade filtration.
• Treatment of 85 patients diagnosed with demyelinating diseases (peripheral and central nervous system), dermatopolymyositis, and myasthenia gravis.
• Combination therapy involving plasmapheresis, lymphocytapheresis, and immunosuppressive drugs.

Main Results:

• Significant and sustained improvement observed in the majority of treated patients.
• Positive outcomes in patients with Guillain-Barré syndrome, multiple sclerosis, and myasthenia gravis.
• The combined therapeutic approach demonstrated a notable alteration in the disease's natural progression.

Conclusions:

• Plasma-exchange therapy, especially when combined with lymphocytapheresis and immunosuppressants, is an effective treatment for a range of neurological disorders.
• This integrated therapeutic strategy can dramatically and durably improve patient outcomes.
• The findings suggest a potential to modify the long-term prognosis of these neurological conditions.