Özkale Murat, Erol Ilknur, Özkale Yasemin, Kozanoğlu İlknur
Department of Pediatrics, Baskent University Faculty of Medicine, Adana Dr Turgut Noyan Teaching and Medical Research Center, Baraj Yolu 1 Durak, Seyhan, 01120, Adana, Turkey.
Department of Pediatric Neurology, Baskent University Faculty of Medicine, Dr Turgut Noyan Teaching and Medical Research Center, Adana, Turkey.
Acta Neurol Belg. 2018 Sep;118(3):451-458. doi: 10.1007/s13760-018-0961-5. Epub 2018 Jun 7.
Therapeutic plasma exchange (TPE) is used in the treatment of neurological, hematological, renal and autoimmune diseases with known or suspected immune pathogenesis. In comparison with neurological diseases of adults, knowledge about the use of TPE in children is incomplete. We report our experience on TPE in children with neurological diseases in a single institution and describe the underlying etiology, clinical course, treatment and outcome. We retrospectively evaluated 22 consecutive children (12 girls, 10 boys, aged 2-16 years) who underwent TPE in the pediatric intensive care unit between January 2010 and January 2017. There were 135 TPE procedures with median 6 TPE sessions per patient. Fresh frozen plasma was used as a replacement fluid in all cases. Most common indications were inflammatory polyneuropathy followed by acquired demyelinating diseases of the central nervous system. Other indications were autoimmune encephalitis and paraneoplastic limbic encephalitis. No mortality was recorded during TPE. The complication rate was 2.2% and consisted of transient events like hypotension and allergic reactions. Therapetic plasma exchange is one of the safe methods of treatment for neuroimmunological disorders in children, with Guillain-Barré syndrome as the most common indication.
治疗性血浆置换（TPE）用于治疗已知或疑似免疫发病机制的神经、血液、肾脏和自身免疫性疾病。与成人神经系统疾病相比，关于TPE在儿童中的应用知识尚不完整。我们报告了在单一机构中对患有神经系统疾病儿童进行TPE的经验，并描述了潜在病因、临床过程、治疗及结果。我们回顾性评估了2010年1月至2017年1月期间在儿科重症监护病房接受TPE的22例连续儿童（12例女孩，10例男孩，年龄2至16岁）。共进行了135次TPE操作，每位患者的TPE疗程中位数为6次。所有病例均使用新鲜冰冻血浆作为置换液。最常见的适应证是炎性多发性神经病，其次是中枢神经系统获得性脱髓鞘疾病。其他适应证为自身免疫性脑炎和副肿瘤性边缘叶脑炎。TPE期间无死亡记录。并发症发生率为2.2%，包括低血压和过敏反应等短暂事件。治疗性血浆置换是儿童神经免疫性疾病的安全治疗方法之一，格林-巴利综合征是最常见的适应证。
