Sahoo Dibyajyoti, Silwal Pragya, Basavarajegowda Abhishekh
Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Asian J Transfus Sci. 2024 Jul-Dec;18(2):248-251. doi: 10.4103/ajts.ajts_18_22. Epub 2022 Sep 28.
Neuromyelitis optica (NMO) is an idiopathic demyelinating disorder characterized mainly by optic neuritis and myelitis, causing gradual loss of vision and deterioration of neurological function. The underlying pathogenesis mainly involves antibodies against aquaporin 4. The effectiveness of therapeutic plasma exchange (TPE) has been shown by many studies across the globe but are only a few from India. We studied ten cases of NMO retrospectively to find out the safety and efficacy of plasma exchange and to know the outcome of those patients who underwent the procedure.
We retrospectively analyzed ten cases of NMO who underwent TPE from January 2017 to July 2021. Out of 153 patients on whom plasma exchange procedures were done during this period, ten cases of NMO were diagnosed and managed with TPE.
In our study, we found that 6 of our patients (60%) had a marked improvement noticed clinically with an increase in baseline power of limbs from 0-2/5 to 3-5/5. However, two patients expired after despite TPE. The other two did not show any improvement. Four of our patients started showing clinical improvement after the 2-3 cycles of treatment. TPE was initiated early (within 5 days). There were no notable events in most of the procedures except in one procedure where the patient developed hypotension, her saturation started to drop, and the procedure had to be aborted.
Our study supports the effectiveness of timely initiation of plasma exchange to improve the overall mortality rate of the patients.
视神经脊髓炎（NMO）是一种特发性脱髓鞘疾病，主要特征为视神经炎和脊髓炎，可导致视力逐渐丧失和神经功能恶化。其潜在发病机制主要涉及抗水通道蛋白4抗体。全球多项研究已证实治疗性血浆置换（TPE）的有效性，但来自印度的相关研究较少。我们对10例NMO患者进行了回顾性研究，以探讨血浆置换的安全性和有效性，并了解接受该治疗的患者的预后情况。
我们回顾性分析了2017年1月至2021年7月期间接受TPE的10例NMO患者。在此期间进行血浆置换的153例患者中，有10例NMO患者被诊断并接受了TPE治疗。
在我们的研究中，我们发现6例患者（60%）临床症状有显著改善，肢体基线肌力从0-2/5增加到3-5/5。然而，尽管进行了TPE治疗，仍有2例患者死亡。另外2例患者没有任何改善。我们的4例患者在2-3个治疗周期后开始出现临床改善。TPE治疗开始较早（在5天内）。除了1例患者在治疗过程中出现低血压、血氧饱和度开始下降，治疗不得不中止外，大多数治疗过程中没有明显事件发生。
我们的研究支持及时进行血浆置换以提高患者总体死亡率的有效性。
