Safety and tolerability of therapeutic plasma exchange in autoimmune neurological diseases - a retrospective single-centre analysis

Neurol Neurochir Pol. 2020;54(4):344-349. doi: 10.5603/PJNNS.a2020.0045. Epub 2020 Jun 18.

Abstract

Clinical rationale for study: The sudden onset of autoimmune neurological diseases often threatens life. In such clinical situations, fast, effective and safe treatment is needed. Therapeutic plasma exchange (TPE) is an option in the treatment of autoimmune disorders.

Aim of study: The aim was to assess the tolerability and safety of membrane-based therapeutic plasma exchange (mTPE) in patients with autoimmune neurological diseases.

Materials and methods: A total of 410 TPE treatments were performed in 91 adult patients. The main reasons for performing TPE were: Guillain-Barre syndrome (39.56%), chronic inflammatory demyelinating polyradiculoneuropathy (20.88%), and myasthenia gravis (17.58%).

Results: A total of 183 (44.6%) mTPE treatments were performed without complications. In 18 (19.8%) patients, there were no complications observed in any of the mTPE procedures (a total of 83 procedures). Serious and life-threatening complications occurred during four (0.97%) mTPEs. The most common abnormality in laboratory tests was hypocalcaemia. In patients with a fibrinogen c oncentration ≥ 2 .63 g /L, m easured before the second plasmapheresis, coagulation in the TPE filter was more f requently o bserved (p = 0 .04).

Conclusions and clinical implications: Our study proves that the use of plasmapheresis conducted by filtration in the treatment of autoimmune neurological diseases is safe and well tolerated.

Keywords: autoimmune neurological diseases; efficacy; side effects; therapeutic plasma exchange.

MeSH terms

  • Adult
  • Guillain-Barre Syndrome
  • Humans
  • Plasma Exchange*
  • Plasmapheresis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating
  • Retrospective Studies