[Treatment of emergency situations in autoimmune diseases with plasma exchange]

Plasma exchange has been applied successfully to treat severely ill patients with autoimmune diseases in recent years. We report on 12 patients with systemic lupus erythematosus (SLE), myasthenia gravis (MG), and Goodpasturés syndrome (GS), that have been treated with membrane plasma separation. Two to three liters of plasma were exchanged per session. Three to nine treatments were done within 1--4 weeks. Human albumin solution was used for replacement of the discarded plasma. Improvement was seen in 3 out of 5 SLE patients, in all 5 myasthenic patients and in one of the two patients with GS. Plasma exchange in combination with immunosuppressive therapy is indicated in states of active autoimmune diseases, not controllable by routine immunosuppression. For long-term treatment, however, immunosuppressive medication should be used.