Miyamoto Satoko, Ohkubo Atsushi, Seshima Hiroshi, Yamamoto Hiroko, Itagaki Ayako, Maeda Takuma, Kurashima Naoki, Mori Takayasu, Iimori Soichiro, Naito Shotaro, Sohara Eisei, Rai Tatemitsu, Uchida Shinichi, Okado Tomokazu
Medical Engineering Center, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan.
Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Ther Apher Dial. 2018 Jun;22(3):255-260. doi: 10.1111/1744-9987.12692. Epub 2018 May 20.
Selective plasma exchange has been shown to be effective in various diseases, but no studies have assessed the benefits of daily treatment. We aimed to investigate the removal dynamics of immunoglobulins, fibrinogen, and factor XIII on three consecutive days in three patients. For mean processed plasma volumes of 1.06 × plasma volume, reductions of 79.6%, 49.3%, and 8.6% were seen for immunoglobulins G, A, and M, respectively. The reductions for fibrinogen and factor XIII were 18.4% and 13.0%, respectively. Removal dynamics were similar for immunoglobulin G-related autoantibodies and immunoglobulin G when using daily selective plasma exchange. Moreover, daily use effectively removed the immunoglobulin G while retaining the coagulation factors. When disease-specific autoantibodies are limited to immunoglobulin G, daily selective plasma exchange may be a useful and safe method of intensive induction treatment for plasmapheresis. However, further study is required in larger cohorts to confirm these findings.
