Dalkiran Tahir, Mercan Mehmet, Ipek Sevcan, Güllü Ufuk Utku, Kandur Yasar, Acipayam Can, Dilber Cengiz
Department of Pediatric Intensive Care, Necip Fazil City Hospital, Kahramanmaras, Türkiye.
Department of Pediatrics, Necip Fazil City Hospital, Kahramanmaras, Türkiye.
J Pediatr Intensive Care. 2022 Feb 3;13(3):282-285. doi: 10.1055/s-0041-1742252. eCollection 2024 Sep.
Therapeutic plasma exchange (TPE) can be applied as an effective therapeutic option in children with hematological, neurological, nephrological, and autoimmune/rheumatic disorders. We aimed to report our TPE experience in pediatric patients. In this article, we retrospectively reviewed the records of pediatric patients who underwent TPE between 2019 and 2021. A total of 128 TPE sessions were performed in 25 patients (13 males,12 females; mean age 59.6 ± 11.7 [3-198] months). The TPE indications were sepsis with/without multiorgan dysfunction syndrome in five patients, acute liver failure, hemolytic uremic syndrome caused by Shiga toxin, and autoimmune hemolytic anemia in three patients, respectively, multiple sclerosis, autoimmune encephalitis, and multisystem inflammatory syndrome in children (MIS-C) in two patients each, and myasthenia gravis crisis, meningococcemia, hemolytic uremic syndrome caused by coronavirus disease 2019, hemophagocytic lymphohistiocytosis, autoimmune encephalitis, and metabolic disease (fatty acid oxidation defect, liver failure) in one patient each. Based on our findings, we proposed that the American Society for Apheresis criteria should be updated according to newly described clinical conditions such as MIS-C.
治疗性血浆置换(TPE)可作为患有血液系统、神经系统、肾脏及自身免疫/风湿性疾病的儿童的一种有效治疗选择。我们旨在报告我们在儿科患者中进行TPE的经验。在本文中,我们回顾性分析了2019年至2021年间接受TPE的儿科患者的记录。共对25例患者(13例男性,12例女性;平均年龄59.6±11.7[3-198]个月)进行了128次TPE治疗。TPE的适应证分别为:5例伴有/不伴有多器官功能障碍综合征的脓毒症、急性肝衰竭、志贺毒素引起的溶血尿毒综合征、3例自身免疫性溶血性贫血、2例多发性硬化症、2例自身免疫性脑炎、2例儿童多系统炎症综合征(MIS-C)、1例重症肌无力危象、1例脑膜炎球菌血症、1例2019冠状病毒病引起的溶血尿毒综合征、1例噬血细胞性淋巴组织细胞增生症、1例自身免疫性脑炎、1例代谢性疾病(脂肪酸氧化缺陷、肝衰竭)。基于我们的研究结果,我们建议美国单采血液成分学会的标准应根据新描述的临床情况(如MIS-C)进行更新。