[The role of plasmapheresis in the treatment of primary and secondary cryoglobulinemia].
The data on monoclonal or mixed cryoglobulinaemia patients admitted to Pavia University's 1st Medical Division since 1970 were examined. Complications included peripheral microangiopathies caused by immune complexes and especially kidney lesions of varying severity caused by immune complexes precipitated in the basal membrane. Although the course of the condition was ameliorated in all patients given immunosuppressive treatment alone, this could not prevent the appearance of progressively worsening kidney conditions. Terminating in severe renal failure these were often complicated by encephalopathies, disturbed microcirculation in the brain and hypertension patients given plasmapheresis at an early stage, at the first sign of renal or brain circulation problems, responded brilliantly with regression of all clinical symptoms. Where plasmapheresis was not given until an advanced stage of the kidney disease, a satisfactory improvement was obtained and the quality and expectancy of life enhanced, even though a total cure was not achieved. Regular cycles of plasmapheresis indubitably protect the patient from irreversible renal or microvascular conditions so that immunosuppressive treatment can effectively control the cryoglobulinaemia.
D003449:Cryoglobulinemia / Q000628:therapy*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010956:Plasmapheresis
D007166:Immunosuppressive Agents; D006493:Heparin
Ruolo della plasmaferesi nel trattamento delle crioglobulinemie primarie e secondarie.