title: [Plasmapheresis in extra-intestinal manifestations of Crohn's disease].
abstract: An assessment was undertaken of the value of plasmapheresis in patients with circulating immune complexes and/or extraintestinal manifestations of Crohn's disease (arthritis, iridocyclitis, erythema nodosum, pyoderma gangrenosum, stomatitis, fever). In 17 patients aged 20 to 50 years (median 34 years) 46 plasmaphereses were performed using a continuous flow-cell separator. Before and after plasmaphereses the concentrations of circulating immune complexes, of complement C4, of the immunoglobulins IgG and IgM and of the proteins alpha-1-antitrypsin, CRP, prealbumin and beta-lipoprotein were determined. 71% of patients given plasmaphereses showed clinical remission of the extraintestinal manifestations and 85% demonstrated a reduction of circulating immune complexes. Clinical follow-up of the patients was documented by the Crohn's Disease Activity Index (CDAI), which was reduced by plasmaphereses to a highly significant degree (p less than 0.005). For patients displaying an acute phase of Crohn's disease with extraintestinal manifestations and/or circulating immune complexes plasmapheresis represents an effective mode of therapy, which, moreover, lacks serious side effects.
mesh_terms: D000328:Adult; D000936:Antigen-Antibody Complex / Q000032:analysis; D001168:Arthritis / Q000209:etiology / Q000628:therapy*; D002097:C-Reactive Protein / Q000276:immunology; D003181:Complement C4 / Q000276:immunology; D003424:Crohn Disease / Q000150:complications*; D004893:Erythema Nodosum / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008077:Lipoproteins, LDL / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D011228:Prealbumin / Q000276:immunology; D011711:Pyoderma / Q000209:etiology / Q000628:therapy; D014606:Uveitis, Anterior / Q000209:etiology / Q000628:therapy; D000515:alpha 1-Antitrypsin / Q000276:immunology
chemical_list: D000936:Antigen-Antibody Complex; D003181:Complement C4; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008077:Lipoproteins, LDL; D011228:Prealbumin; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein
vernacular_title: Plasmapherese bei extraintestinalen Manifestationen des Morbus Crohn.