Efficacy of Plasmapheresis in the Treatment of Steatohepatitis Accompanied by Obesity and Hypersideremia

Abstract

Aim of the study: To establish the effectiveness of discrete plasmapheresis in the treatmentof patients with nonalcoholic fatty liver disease accompanied by hyperferritinemia andconcomitant obesity.Material and methods. The study is based on the clinical observations of 18 patientswith non-alcoholic steatohepatitis accompanied by hyperferritinemia and concomitantobesity. Each patient was undergoing the basic therapy as well as the sessions of discreteplasmapheresis for 10-14 days, which led to the removal of 17-20% of the volume ofcirculating plasma during each procedure, the total of which amounts to about 1-1.5 ofthe circulating plasma volume.Results. As a result of the two-week treatment, the patients' well-being improvedsignificantly, their efficiency increased, and previously elevated levels of ferritin (1.29times in men and 1.21 in women) and serum iron (2.7 times) decreased. The initiallyelevated level of total cholesterol also decreased significantly (2.34 times), and due toVLDL (7.86 times) and triacylglycerols – 9.78 times. The atherogenic factor decreasedfrom 3.8 to 1.5. (2.5 times). The sizeable decrease was observed in the uric acid content– 1.77 times, ALT activity – 1.55 times, LDH – 1.77 times, LF – 1.42 times, GGTP – 4.0times (p <0.05).Conclusions. Inclusion of the discrete plasmapheresis sessions to the treatmentprogram of non-alcoholic steatohepatitis at comorbidity with hyperferritemia andobesity enables to reduce significantly the initially elevated blood levels of ferritin,serum iron, LPVLD, triacylglycerols, cholesterol, AAT, LDHG, AP, GGTF activity.