Nieto-Aristizábal Ivana, Vivas Álvaro J, Ruiz-Montaño Pablo, Aragón Cristian C, Posso-Osorio Iván, Quiñones Jairo, Rivillas Julián Alejandro, Tobón Gabriel J
GIRAT: Grupo de Investigación en Reumatología, Autoinmunidad y Medicina Traslacional, Universidad Icesi and Fundación Valle del Lili, Cra. 98 18-49, Cali, Colombia.
Medical School, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia.
Autoimmune Dis. 2020 Jul 31;2020:3484659. doi: 10.1155/2020/3484659. eCollection 2020.
Therapeutic plasma exchange (TPE) is commonly used as treatment of certain autoimmune neurological diseases (ANDs), and its main objective is the removal of pathogenic autoantibodies. Our aim was to describe the clinical profile and the experience with the usage of TPE in patients with ANDs at our institution.
This is an observational retrospective study, including medical records of patients with diagnosis of ANDs who received TPE, between 2011 and 2018. Characteristics of TPE, such as number of cycles, type of replacement solution, and adverse effects, were evaluated. The modified Rankin Scale (mRS) was applied to measure the clinical response after the therapy.
187 patients were included with the following diagnoses: myasthenia gravis (MG), = 70 (37%); Guillain-Barré syndrome (GBS), = 53 (28.3%), neuromyelitis optica spectrum disorders (NMOSD), = 35 (18.7%); chronic inflammatory demyelinating polyneuropathy (CIDP), = 23 (12.2%); and autoimmune encephalitis (AE), = 6 (3.2%). The most used types of replacement solution were albumin ( = 131, 70%) and succinylated gelatin ( = 45, 24%). All patients received a median of five cycles (IQR 5-5). Hypotension and hydroelectrolytic disorders were the main complications. After TPE, 99 patients (52.9%) showed improvement in the mRS scores and a statistical significance ( < 0.05) was seen between the admission score and after TPE for every diagnosis except for CIDP.
TPE has an adequate safety profile, and improvement in functionality in treated patients reflects its effectiveness.
治疗性血浆置换（TPE）常用于治疗某些自身免疫性神经疾病（ANDs），其主要目的是清除致病性自身抗体。我们的目的是描述我院ANDs患者的临床特征以及TPE的使用经验。
这是一项观察性回顾性研究，纳入了2011年至2018年间诊断为ANDs并接受TPE治疗的患者的病历。评估了TPE的特征，如置换次数、置换液类型和不良反应。采用改良Rankin量表（mRS）来衡量治疗后的临床反应。
共纳入187例患者，诊断如下：重症肌无力（MG）70例（37%）；吉兰 - 巴雷综合征（GBS）53例（28.3%），视神经脊髓炎谱系障碍（NMOSD）35例（18.7%）；慢性炎症性脱髓鞘性多发性神经病（CIDP）23例（12.2%）；自身免疫性脑炎（AE）6例（3.2%）。最常用的置换液类型是白蛋白（131例，70%）和琥珀酰明胶（45例，24%）。所有患者接受的置换次数中位数为5次（四分位数间距5 - 5）。低血压和水电解质紊乱是主要并发症。TPE后，99例患者（52.9%）的mRS评分有所改善，除CIDP外，每种诊断在入院时评分与TPE后评分之间均有统计学意义（<0.05）。
TPE具有良好的安全性，治疗患者功能的改善反映了其有效性。
