Apheresis in treatment of acute inflammatory demyelinating disorders.
Therapeutic apheresis has reached an important value in the treatment of neurologic disorders. In the indication of acute relapses of inflammatory demyelinating conditions plasma exchange (PE) is currently mentioned in guidelines in adults and children. Immunoadsorption (IA) is a younger but more selective apheresis method. Compared to PE, data on IA in these indications are less substantiated. Hitherto existing studies indicate IA as effective and safe with similar response rates versus PE. Our own study of 140 adult patients treated with PE or IA in steroid refractory multiple sclerosis or neuromyelitis optica affirm previous findings showing no significant difference in efficacy and treatment safety. Analogue to adult patients, children seem to benefit from apheresis therapy in steroid resistant inflammatory demyelinating conditions but their treatment implies certain challenges concerning physiology, anatomy and psychological aspects necessitating a multidisciplinary therapeutic setting.
Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Germany.
Johannes
J
Mühlhausen
Department of Neurology, Georg-August-University Göttingen, Germany.
Bernd
B
Kitze
Department of Pediatrics and Pediatric Neurology, Georg-August-University Göttingen, Germany.
Peter
P
Huppke
Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Germany.
Gerhard A
GA
Müller
Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Germany. Electronic address: mkoziolek@med.uni-goettingen.de.
Michael J
MJ
Koziolek
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D007163:Immunosorbent Techniques / Q000009:adverse effects; D008297:Male; D009103:Multiple Sclerosis / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D009471:Neuromyelitis Optica / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D018579:Patient Selection; D010951:Plasma Exchange; D012307:Risk Factors; D016896:Treatment Outcome
D015415:Biomarkers
Acute disseminated encephalomyelitis; Children; Immunoadsorption; Multiple sclerosis; Neuromyelitis optica; Pediatric; Plasmapheresis