title: Plasmapheresis in paraproteinemia.
abstract: Indications, results, techniques, laboratory monitoring and complications of therapeutic plasmapheresis in patients with symptomatic paraproteinemia are reviewed. In paraproteinemia associated with severe complications plasma-pheresis has been used successfully as an emergency treatment, as a treatment that reduces temporarily the paraprotein level until reduction of resynthesis is reached by cytotoxic therapy, or as a longterm adjuvant therapy in cases of slowly proliferating plasmacytoma or lymphoma. Plasmapheresis has not been shown to influence the underlying malignant process. Paraprotein-related complications that can be reduced by plasmapheresis are hyperviscosity, hypervolemia, haemorrhagic diathesis, cryoglobulinemic symptoms, rapidly deteriorating renal insufficiency, visual impairment, and neurologic disturbances. Technically, large-pored plasma filters have some advantage as compared to centrifugation techniques. Paraprotein-specific complications of therapeutic plasmapheresis are rare. As an ancillary treatment, therapeutic plasmapheresis has expanded the therapeutic tools in the management of paraproteinemia.
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy; D001809:Blood Viscosity; D001810:Blood Volume; D003318:Corneal Opacity / Q000628:therapy; D003449:Cryoglobulinemia / Q000209:etiology / Q000628:therapy; D006474:Hemorrhagic Disorders / Q000628:therapy; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D009461:Neurologic Manifestations / Q000628:therapy; D010265:Paraproteinemias / Q000150:complications / Q000628:therapy*; D010266:Paraproteins / Q000032:analysis; D010951:Plasma Exchange; D010956:Plasmapheresis / Q000379:methods; D011317:Priapism / Q000628:therapy
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010266:Paraproteins