Plasma exchange for systemic lupus erythematosus.
Efficacy of plasma exchange in patients with systemic lupus erythematosus has not been supported by the results of the first non-controlled and retrospective studies. Nonetheless, they remain relevant for some selected patients with life-threatening manifestations and/or severe therapy-resistant manifestations. They can be used as an adjuvant therapy in combination with corticosteroids and, when required, other immunosuppressant(s) for refractory renal disease, alveolar hemorrhage, some neuropsychiatric manifestations, thrombotic thrombocytopenic purpura, catastrophic antiphospholipid syndrome, hyperviscosity syndrome or symptomatic cryoglobulinemia. The use of newer technologies, like immunoadsorption, possibly in combination with recent biologics, might, in the future, offer some new perspectives for extracorporeal therapy of systemic lupus erythematosus.
Pagnoux
Christian
C
Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, 27, rue du Faubourg Saint-Jacques, 75689 Paris Cedex 14, France. christian.pagnoux@cch.aphp.fr
D016736:Antiphospholipid Syndrome / Q000628:therapy; D002986:Clinical Trials as Topic; D003449:Cryoglobulinemia / Q000209:etiology / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000628:therapy*; D009205:Myocarditis / Q000209:etiology / Q000628:therapy; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000628:therapy; D012189:Retrospective Studies