Schooneman F, Gérard A
Nouv Presse Med. 1982 Dec 25;11(52):3847-51.
Since plasma is largely involved in autoimmune diseases, plasma exchanges have been used to treat these patients. In the first part of this paper the authors review the indications for plasmapheresis, which they divide into two groups: autoimmune diseases proper, and diseases with autoimmune phenomena. In the second part, the results available in the literature are analyzed. In many cases, it is extremely difficult to form an opinion, since the methods vary from one group of workers to the other. Unquestionably, improvement was observed in bullous pemphigus and pemphigoid, in Goodpasture's syndrome, in glomerulonephritis with autoantibodies and in myasthenia. In other cases, dramatic improvement was sometimes observed (notably in some cases of acute polyradiculoneuritis), but the small number of patients in each series makes it impossible to separate the effects of plasma exchanges and those of the immunosuppressive treatment frequently administered concomitantly.
由于血浆在自身免疫性疾病中起着重要作用,血浆置换已被用于治疗这些患者。在本文的第一部分,作者回顾了血浆置换的适应症,他们将其分为两组:自身免疫性疾病本身以及伴有自身免疫现象的疾病。在第二部分,分析了文献中可得的结果。在许多情况下,很难形成定论,因为不同研究团队的方法各不相同。毫无疑问,在大疱性天疱疮、类天疱疮、古德帕斯彻综合征、伴有自身抗体的肾小球肾炎以及重症肌无力中观察到了病情改善。在其他情况下,有时会观察到显著改善(尤其是在一些急性多发性神经根神经炎病例中),但每个系列中的患者数量较少,使得无法区分血浆置换的效果和经常同时给予的免疫抑制治疗的效果。