Chongqing Key Laboratory of Neurology, Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, China.
Front Immunol. 2019 Feb 27;10:324. doi: 10.3389/fimmu.2019.00324. eCollection 2019.
Plasma exchange has been widely used in autoimmune neurological diseases and is the standard treatment for myasthenia gravis crisis and Guillain-Barre syndrome. A growing body of research suggests that, in the clinical application of steroid-responsive encephalopathy, such as for Hashimoto's encephalopathy, limbic encephalitis, systemic lupus erythematosus encephalopathy, ANCA-associated vasculitis encephalopathy, and acute disseminated encephalomyelitis, plasma exchange is a safe, and effective option when steroids or other immunosuppressive therapies are ineffective in the short term or when contraindications are present. Additionally, plasma exchange can also be used alone or in combination with steroids, immunoglobulins, or other immunosuppressive agents to treat steroid-responsive encephalopathy. This paper reviews the clinical application of plasma exchange in steroid-responsive encephalopathy, including its indications, onset time, course, curative effects, and side effects.
血浆置换已广泛应用于自身免疫性神经系统疾病，是治疗重症肌无力危象和格林-巴利综合征的标准方法。越来越多的研究表明，在临床应用中，对于类固醇反应性脑病，如桥本脑病、边缘性脑炎、系统性红斑狼疮脑病、抗中性粒细胞胞浆抗体相关性血管炎脑病和急性播散性脑脊髓炎，当短期应用类固醇或其他免疫抑制剂无效或存在禁忌证时，血浆置换是一种安全有效的选择。此外，血浆置换还可单独或与类固醇、免疫球蛋白或其他免疫抑制剂联合用于治疗类固醇反应性脑病。本文综述了血浆置换在类固醇反应性脑病中的临床应用，包括其适应证、发病时间、病程、疗效和不良反应。
