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Specificity of plasmapheresis in the treatment of chronic relapsing polyneuropathy
A 27-year-old woman with an eight year history of chronic relapsing polyneuropathy presented in her fifth relapse. Raised immune complexes prompted a trial of plasmapheresis. Remarkable clinical improvement was seen after the second exchange. Complete remission was obtained after ten treatments. Subsequently, further relapses have occurred, each responsive to plasmapheresis. The effect of plasma exchange in this patient appears to be unique as neither charcoal perfusion nor plasma infusion per se proved efficacious. The patient is currently maintained with weekly plasma exchanges, her course complicated by supervening hepatitis B antigenemia. The clearance of immune complexes observed during plasmapheresis raises the possibility that removal of a serum factor is responsible for her clinical improvement and that patients with such a factor may benefit from plasmapheresis.
A 27-year-old woman with an eight year history of chronic relapsing polyneuropathy presented in her fifth relapse. Raised immune complexes prompted a trial of plasmapheresis. Remarkable clinical improvement was seen after the second exchange. Complete remission was obtained after ten treatments. Subsequently, further relapses have occurred, each responsive to plasmapheresis. The effect of plasma exchange in this patient appears to be unique as neither charcoal perfusion nor plasma infusion per se proved efficacious. The patient is currently maintained with weekly plasma exchanges, her course complicated by supervening hepatitis B antigenemia. The clearance of immune complexes observed during plasmapheresis raises the possibility that removal of a serum factor is responsible for her clinical improvement and that patients with such a factor may benefit from plasmapheresis.