title: Therapeutic apheresis in pediatric patients with acute CNS inflammatory demyelinating disease.
abstract: OBJECTIVE
  In adults, plasma exchange (PE) has been shown to be an efficient treatment for severe relapses of acute inflammatory CNS demyelinating diseases. The aim of this study was to evaluate the safety and efficacy of this treatment in pediatric patients.
  
  
  METHODS
  We retrospectively analyzed a single-center cohort of pediatric patients with inflammatory CNS demyelinating disorders who underwent apheresis between 2007 and 2011.
  
  
  RESULTS
  Ten patients (mean age: 11.6 ± 3.4 years) with an acute relapse of multiple sclerosis (n = 5), neuromyelitis optica (n = 2) or acute disseminated encephalomyelitis were included. All received methylprednisolone prior to treatment with either PE (n = 5) or immunoadsorption (n = 5). Apheresis-related side effects were either self-limiting or easily managed. EDSS (Expanded Disability Status Scale) improved in 7 of 8 patients during apheresis and in all patients within 30 days from a median of 7.5 to 1 (p < 0.01). The visual acuity initially worsened during the procedure in 3 of 7 affected eyes (mean 0.09), but improved in all at follow-up (mean: 0.5; p = 0.008).
  
  
  CONCLUSIONS
  Apheresis was well tolerated and associated with a favorable outcome in all pediatric patients similar to reports in adults.
authors.affiliation: Department of Nephrology and Rheumatology, Georg August University Göttingen, Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Koziolek
authors.forename: Johannes
authors.initials: J
authors.lastname: Mühlhausen
authors.forename: Tim
authors.initials: T
authors.lastname: Friede
authors.forename: David
authors.initials: D
authors.lastname: Ellenberger
authors.forename: Matthias
authors.initials: M
authors.lastname: Sigler
authors.forename: Brenda
authors.initials: B
authors.lastname: Huppke
authors.forename: Jutta
authors.initials: J
authors.lastname: Gärtner
authors.forename: Gerhard-Anton
authors.initials: GA
authors.lastname: Müller
authors.forename: Peter
authors.initials: P
authors.lastname: Huppke
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007249:Inflammation / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000627:therapeutic use; D010951:Plasma Exchange / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000893:Anti-Inflammatory Agents; D018696:Neuroprotective Agents; D008775:Methylprednisolone