Guillot B, Donadio D, Guilhou J J, Courren C, Meynadier J
Presse Med. 1983 Sep 3;12(30):1855-8.
Ten patients with bullous pemphigoid underwent low volume plasma exchange (1/3 to 1/2 of the plasmatic mass) 3 times a week for 2 to 6 weeks followed, in some of them, by maintenance corticosteroid therapy. Eight patients benefited from this treatment. Complete control of the disease was obtained with PE alone in 3: low-dose corticosteroids were sufficient to procure remission in 2, and dosage could be reduced in 3 patients who previously required high doses of corticosteroids. No serious side-effects were recorded. The best results were observed in patients who had been ill for less than 3 months. Thus, low volume plasma exchanges make it possible to obtain clinical improvement while avoiding the rebound phenomena sometimes observed after high volume plasma exchanges. Circulating immune complexes and pemphigoid antibodies usually decreased under treatment, but there was no close correlation between these changes and therapeutic effectiveness.
10例大疱性类天疱疮患者接受了小容量血浆置换(血浆量的1/3至1/2),每周3次,持续2至6周,其中部分患者随后接受维持性皮质类固醇治疗。8例患者从该治疗中获益。仅通过血浆置换就使3例患者的疾病得到完全控制:2例患者使用低剂量皮质类固醇足以实现缓解,3例先前需要高剂量皮质类固醇的患者其剂量得以减少。未记录到严重副作用。在患病时间少于3个月的患者中观察到了最佳效果。因此,小容量血浆置换能够实现临床改善,同时避免有时在大容量血浆置换后出现的反跳现象。治疗期间循环免疫复合物和类天疱疮抗体通常会减少,但这些变化与治疗效果之间没有密切相关性。