Ferri C, Gremignai G, Bombardieri S, Moriconi L, Pontrandolfo A, Vitali C, Fosella P V, Pasero G
Ric Clin Lab. 1986 Apr-Jun;16(2):403-11. doi: 10.1007/BF02909369.
Prolonged plasma-exchange without addition of cytotoxic agents was employed in 16 patients with mixed cryoglobulinemia and kidney, liver or neurologic involvement. Patients with rapidly progressive renal failure or active and reversible lesions generally improved after plasma-exchange, as well as those with a recently occurring sensory-motor peripheral neuropathy. In 4 out of 6 patients with mixed cryoglobulinemia and chronic active hepatitis, plasma-exchange was followed by either normalization or significant reduction of liver enzymes and bromosulfophthalein retention. In all cases responding to plasma-exchange the beneficial effects were evident after the first 2-3 weeks of treatment, while symptoms did not generally recur when the procedures were either slowly tapered or discontinued. Although the pathogenetic mechanism(s) of action of plasma-exchange remains largely unknown, preliminary data indicate that these procedures induce quantitative as well as qualitative changes in the immune system.
16例合并肾脏、肝脏或神经受累的混合性冷球蛋白血症患者接受了不添加细胞毒性药物的长时间血浆置换治疗。快速进展性肾衰竭或活动性可逆性病变的患者，以及近期发生感觉运动性周围神经病的患者，血浆置换后一般病情有所改善。6例合并慢性活动性肝炎的混合性冷球蛋白血症患者中，有4例在血浆置换后肝酶及磺溴酞钠潴留恢复正常或显著降低。在所有对血浆置换有反应的病例中，治疗开始后的前2至3周有益效果就很明显，而且当治疗程序逐渐缓慢减少或停止时，症状一般不会复发。虽然血浆置换的致病作用机制在很大程度上仍不清楚，但初步数据表明，这些治疗程序会引起免疫系统在数量和质量上的变化。
