Morgan Shanna M, Zantek Nicole D, Carpenter Adam F
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
J Clin Apher. 2014 Jun;29(3):171-7. doi: 10.1002/jca.21304. Epub 2013 Oct 17.
Neuromyelitis optica (NMO) is a relapsing inflammatory disease of the central nervous system that predominantly affects the spinal cord and optic nerves. The clinical hallmark of the disease is a step-wise deterioration of visual and spinal cord function. This study reviews patients with steroid resistant relapsing NMO presenting for therapeutic plasma exchange (TPE) at our institution from December 2005 to December 2012. A total of five patients were treated with single volume TPE. Both subjective and objective clinical response to TPE was estimated by three different sources (the patient, a Transfusion Medicine physician, and the treating Neurologist) with the patient and Transfusion Medicine physician's final assessment of response made at the time of the last TPE in the series and the treating neurologist's assessment of response made at the time of the next neurological exam after the last TPE. A total of 17 TPE series were performed with the average course of therapy being three series (ranged 1-5) with five TPE (ranged 3-7) per series. All patients demonstrated improvement with each series of TPE and all procedures were well tolerated with only transient and well-described reactions all of which were successfully resolved with minor or no sequelae.
视神经脊髓炎（NMO）是一种中枢神经系统的复发性炎性疾病，主要影响脊髓和视神经。该疾病的临床特征是视觉和脊髓功能逐步恶化。本研究回顾了2005年12月至2012年12月期间在我们机构接受治疗性血浆置换（TPE）的类固醇抵抗性复发性NMO患者。共有5例患者接受了单剂量TPE治疗。TPE的主观和客观临床反应由三个不同来源（患者、输血医学医生和主治神经科医生）评估，患者和输血医学医生在该系列最后一次TPE时进行最终反应评估，主治神经科医生在最后一次TPE后的下一次神经检查时进行反应评估。共进行了17个TPE疗程，平均治疗疗程为3个疗程（范围1 - 5），每个疗程进行5次TPE（范围3 - 7）。所有患者在每个TPE疗程后均有改善，所有操作耐受性良好，仅有短暂且描述明确的反应，所有这些反应均成功解决，后遗症轻微或无后遗症。
