Efficacy and Safety of Therapeutic Plasma Exchange in Children with Neuroimmunological Disorders: A Limited Unicentral Study
Iranian Journal of Child Neurology,
Vol. 18 No. 2 (2024),
12 March 2024
,
Page 31-41
https://doi.org/10.22037/ijcn.v18i1.40139
Abstract
Objectives
Therapeutic plasma exchange (TPE) is a plasmapheresis procedure whose Safety data for pediatric neuro-immunological disorders (PNID) is confined. The present research documents TPE’s safety and feasibility data in these conditions.
Materials & Methods
The current study involved six distinct groups of patients with PNID undergoing TPE: neuromyelitis optic spectrum disorder (NMOSD), autoimmune encephalitis (AIE), acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), Guillain-Barre syndrome (GBS), and optic neuritis (ON). This study documented complications related to each TPE process. In addition, TPE’s efficacy was studied in these patients.
Results
The present study recorded adverse effects in 18 patients with PNID that received 121 TPE cycles: five cycles (4.13%) in MS, three(2.48%) in AIE subgroup, one (0.82%) in ADEM, and two (1.65%) in GBS. No severe complications were observed among the patients.
Conclusion
Patients with PNID tolerated therapeutic plasma exchange, which was a safe process.
- Therapeutic plasma exchange (TPE)
- Pediatric neuro-immunological disorders (PNID)
How to Cite
References
[2] Gulluoglu H, Uysal H. Plasma Exchange in Neuroimmunologic Disorders. InEUROPEAN JOURNAL OF NEUROLOGY 2022 Jul 1 (Vol. 29, pp. 819-819). 111 RIVER ST, HOBOKEN 07030-5774, NJ USA: WILEY.
[3] Zhang Y, Huang HJ, Chen WB, Liu G, Liu F, Su YY. Clinical efficacy of plasma exchange in patients with autoimmune encephalitis. Annals of Clinical and Translational Neurology. 2021 Apr;8(4):763-73.
[4] MCCOMBE JA, KAPADIA R, SMYTH P, BLEVINS G, DEROBLES P, ALIKHANI K, HAHN C. 2022 Alberta Consensus Guidelines for Diagnosis and Treatment of Autoimmune Encephalitis.
[5] Hardy D. Autoimmune Encephalitis in Children. Pediatric Neurology. 2022 May 13.
[6] Wright MA, Trandafir CC, Nelson GR, Hersh AO, Inman CJ, Zielinski BA. Diagnosis and Management of Suspected Pediatric Autoimmune Encephalitis: A Comprehensive, Multidisciplinary Approach and Review of Literature. Journal of Child Neurology. 2022 Mar;37(4):303-13.
[7] Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, Cortese I, Dale RC, Gelfand JM, Geschwind M, Glaser CA. A clinical approach to diagnosis of autoimmune encephalitis. The Lancet Neurology. 2016 Apr 1;15(4):391-404.
[8] Shah YD, Eksambe P, Fomani K, Louie J, Shefali K, Kothare S. Feasibility & safety of plasma exchange in paediatric neuro-immunology: A single center experience. European Journal of Paediatric Neurology. 2020 Jul 1;27:94-7.
[9] Massa S, Fracchiolla A, Neglia C, Argentiero A, Esposito S. Update on acute disseminated encephalomyelitis in children and adolescents. Children. 2021 Apr 6;8(4):280.
[10] Fadda G, Armangue T, Hacohen Y, Chitnis T, Banwell B. Paediatric multiple sclerosis and antibody-associated demyelination: clinical, imaging, and biological considerations for diagnosis and care. The Lancet Neurology. 2021 Feb 1;20(2):136-49.
[11] Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barré syndrome. The Lancet. 2021 Mar 27;397(10280):1214-28.
[12] Petzold A, Fraser CL, Abegg M, Alroughani R, Alshowaeir D, Alvarenga R, Andris C, Asgari N, Barnett Y, Battistella R, Behbehani R. Diagnosis and classification of optic neuritis. The Lancet Neurology. 2022 Sep 27.
[13] US Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Published November 27, 2017.
[14] Seyhanli A, Yavuz B, Selimoglu I, Sengun IS, Aslan AT, Ozsan GH, Alacacioglu I, Demirkan F. Therapeutic plasma exchange in neurological diseases: Eleven years experience at a tertiary care center in Turkey. Therapeutic Apheresis and Dialysis. 2022 Apr;26(2):465-70.
[15] Özkale M, Erol I, Özkale Y, Kozanoğlu İ. Overview of therapeutic plasma exchange in pediatric neurology: a single-center experience. Acta Neurologica Belgica. 2018 Sep;118(3):451-8.
[16] Wu Y, Zhong L, Geng J. Neuromyelitis optica spectrum disorder: Pathogenesis, treatment, and experimental models. Multiple sclerosis and related disorders. 2019 Jan 1;27:412-8.
[17] Kasprisin DO. Therapeutic apheresis in children. In Therapeutic hemapheresis 2019 Aug 14 (pp. 73-89). CRC Press.
[18] Couriel D, Weinstein R. Complications of therapeutic plasma exchange: a recent assessment. Journal of clinical apheresis. 1994;9(1):1-5.
[19] Nizar OA, Rai P, Rao SN, Shenoy MP. Plasmapheresis: A retrospective audit of procedures from a tertiary care center in Southern India. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. 2017 Dec;21(12):857.
[20] George JN, Terrell DR, Swisher KK, Vesely SK. Lessons learned from the Oklahoma thrombotic thrombocytopenic purpura‐hemolytic uremic syndrome registry. Journal of Clinical Apheresis: The Official Journal of the American Society for Apheresis. 2008;23(4):129-37.
[21] Kara A, Turgut S, Çağlı A, Şahin F, Oran E, Tunç B. Complications of therapeutic apheresis in children. Transfusion and Apheresis Science. 2013 Jun 1;48(3):375-6.
[22] Paglialonga F, Schmitt CP, Shroff R, Vondrak K, Aufricht C, Watson AR, Ariceta G, Fischbach M, Klaus G, Holtta T, Bakkaloglu SA. Indications, technique, and outcome of therapeutic apheresis in European pediatric nephrology units. Pediatric Nephrology. 2015 Jan;30(1):103-11.
[23] Cortina G, Ojinaga V, Giner T, Riedl M, Waldegger S, Rosales A, Trojer R, Hofer J. Therapeutic plasma exchange in children: one center's experience. Journal of Clinical Apheresis. 2017 Dec;32(6):494-500.
[24] Cortina G, McRae R, Chiletti R, Butt W. Therapeutic plasma exchange in critically ill children requiring intensive care. Pediatric Critical Care Medicine. 2018 Feb 1;19(2):e97-104.
[25] Lu J, Zhang L, Xia C, Tao Y. Complications of therapeutic plasma exchange: A retrospective study of 1201 procedures in 435 children. Medicine. 2019 Dec;98(50).
[26] Eyre M, Hacohen Y, Barton C, Hemingway C, Lim M. Therapeutic plasma exchange in paediatric neurology: a critical review and proposed treatment algorithm. Developmental Medicine & Child Neurology. 2018 Aug;60(8):765-79.
- Abstract Viewed: 113 times