Miyamoto Katsuichi, Kusunoki Susumu
Department of Neurology, Kinki University School of Medicine, Osaka, Japan.
Ther Apher Dial. 2009 Dec;13(6):505-8. doi: 10.1111/j.1744-9987.2009.00780.x.
Neuromyelitis optica (NMO) is a relapsing inflammatory condition characterized by selective involvement of the optic nerves and spinal cord. Humoral immune mechanisms play a role in the pathogenesis of NMO. The therapeutic efficacy of plasmapheresis (PP) has been reported in the cases that were poorly controlled with other treatments. Herein, we report four patients with NMO who underwent PP following intensive intravenous corticosteroid therapy. All patients showed definite functional improvement following one to five plasma exchanges. To prevent relapse, these patients were treated with oral prednisolone in combination with azathioprine or cyclophosphamide. Two of the four patients also underwent intermittent PP because treatment with oral agents was unsuccessful. In conclusion, when treatment with oral immunosuppressants is ineffective in reducing recurrences of NMO, an additional PP session should be attempted.
视神经脊髓炎（NMO）是一种复发性炎症性疾病，其特征是视神经和脊髓选择性受累。体液免疫机制在NMO的发病机制中起作用。血浆置换（PP）在其他治疗控制不佳的病例中已报道有治疗效果。在此，我们报告四名在强化静脉注射皮质类固醇治疗后接受PP的NMO患者。所有患者在进行一至五次血浆置换后均显示出明确的功能改善。为预防复发，这些患者接受口服泼尼松龙联合硫唑嘌呤或环磷酰胺治疗。四名患者中有两名也接受了间歇性PP，因为口服药物治疗未成功。总之，当口服免疫抑制剂治疗在减少NMO复发方面无效时，应尝试额外进行一次PP治疗。
