[Treatment of severe or vasculitis associated forms of rheumatoid arthritis by plasma exchanges (author's transl)].
Five patients with typical seropositive rheumatoid arthritis were treated by plasma exchange. All patients had severe affections resistant to conventional treatment, while in four cases the disease involved extra-articular localizations: rheumatoid nodules (3 cases), polyneuritis (1 case), skin necrosis (1 case). Each patient received between 5 and 10 plasma exchanges over a period of 3 to 4 weeks. No major complications were observed. Immediate results were very good in all cases, as shown by absence of clinical expression of the arthritis, marked regression in extra-articular symptoms, and reduction in erythrocyte sedimentation rate without parallel alterations in rheumatoid factor levels. Improvement lasted for only a few weeks in 3 patients, in one case preceded by an acutely painful episode. In the remaining 2 cases, with associated vasculitis, improvement has been sustained for a period that now exceeds one year. Results are compared with those reported in the published literature, and the mode of action and indications for plasma exchange in rheumatoid arthritis discussed.
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology / Q000628:therapy*; D001799:Blood Sedimentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010951:Plasma Exchange / Q000009:adverse effects; D011115:Polyneuropathies / Q000209:etiology; D012008:Recurrence; D012217:Rheumatoid Factor / Q000032:analysis; D012218:Rheumatoid Nodule / Q000209:etiology; D012867:Skin / Q000473:pathology
D012217:Rheumatoid Factor
Le traitement des formes graves et malignes de polyarthrite rhumatoïde par les échanges plasmatiques.