Feasibility &amp; safety of plasma exchange in paediatric neuro-immunology: A single center experience

Shah, Yash D.; Eksambe, Padmavati; Fomani, Katayoun; Louie, James S.; Karkare, Shefali; Kothare, Sanjeev V.

doi:10.1016/j.ejpn.2020.04.001

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…Several studies have demonstrated that PE during the acute attack benefits patients with NMOSD ( 10 , 23 , 24 ). However, these studies mainly included adults, and only a few studies have evaluated the safety and effectiveness of PE in children with NMOSD ( 12 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of plasma exchange treatment in children with AQP4-IgG positive neuromyelitis optica spectrum disorder

Lin

Liu

et al. 2023

Front. Immunol.

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Neuromyelitis optica spectrum disorder (NMOSD), a severe demyelinating disease, is rare among children. Plasma exchange (PE) is widely used as a salvage therapy for severe and corticosteroid-unresponsive patients with NMOSD. Presently, there are limited studies on the safety and efficacy of PE in children with NMOSD. Herein, we report the case of six children with NMOSD who received PE along with the outcomes and adverse events. All six children (female, age at onset 4 years 9 months–13 years 2 months) were AQP4-IgG positive and received standard PE using the COM.TEC Cell Separator. The interval between NMOSD onset and PE was 29 days (range 10–98). Only one patient (P3) who received PE 10 days after acute exacerbations exhibited clinical improvement. Her left visual acuity increased from 0.06 to 0.6 (spectacle-corrected visual acuity was 1.0) and her EDSS score decreased from 4 to 3 points. The other five patients had no clinical improvement and no EDSS scores changes after PE. Adverse events included rashes (P1, P3), acute non-occlusive thrombosis of the internal jugular vein (P1), and thrombocytopenia (P2). In conclusion, the timing of PE initiation as a rescue therapy for severe and corticosteroid-unresponsive pediatric AQP4-IgG positive NMOSD may be crucial to treatment efficacy, and early initiation of PE may be associated with a better outcome. Furthermore, PE has the potential risk for clinically significant adverse effects that should be considered before initiating the therapy and should be weighed against potential benefits.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of plasma exchange treatment in children with AQP4-IgG positive neuromyelitis optica spectrum disorder

Lin

Liu

et al. 2023

Front. Immunol.

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“…The efficacy of TPE in various pediatric neuroimmunological disorders has been demonstrated in the existing literature (4)(5)(6)(7). Recently, Akcay et al (8) evaluated the effectiveness of TPE in patients with multiple sclerosis (MS), transverse myelitis (TM), and ADEM, using EDSS and GS scoring criteria.…”

Section: Introductionmentioning

confidence: 99%

Clinical Improvement with Therapeutic Plasma Exchange in Neuroimmunological Children: A Single Center Experience

Nikkhah¹,

Nasehi²,

Momtazmanesh³

et al. 2023

Iran J Pediatr

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Background: Neuroimmunological diseases in children encompass a range of disorders that lead to neurological complications in patients due to immune responses and systemic circulating antibodies. Limited research has been conducted on therapeutic plasma exchange’s efficacy and potential side effects in children with neuroimmunological diseases. Objectives: This study aimed to investigate this procedure’s effectiveness and potential side effects in children afflicted by these diseases. Methods: This cross-sectional study examined a cohort of 18 children with neuroimmunological diseases who were admitted to the neurology department of Mofid Hospital over one year from March 2021 and underwent therapeutic plasma exchange. Results: The study included 18 patients, with an equal distribution of 9 females and 9 males. A total of 121 procedures were performed across 6 different disease groups: Multiple Sclerosis (22%, n = 4), Autoimmune Encephalitis (22%, n = 4), Neuromyelitis Optica Spectrum Disorder (22%, n = 4), Guillain-Barré syndrome (22%, n = 4), Acute Disseminated Encephalomyelitis (6%, n = 1), and Optic Neuritis (6%, n = 1). Following the plasma exchange, 17 patients (95%) showed immediate clinical improvement, while one patient diagnosed with optic neuritis did not respond to the treatment. During the follow-up period, 14 patients (78%) demonstrated significant improvement, one patient (6%) showed moderate improvement, and two patients (11%) exhibited mild improvement compared to their pre-plasmapheresis condition. Laboratory examinations revealed that only one patient experienced thrombocytopenia, which resolved without requiring treatment. No complications were observed during the follow-up visits for any of the patients. Conclusions: Plasma exchange is a safe procedure for children with neuroimmunological diseases and yields favorable clinical responses.

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Therapeutic plasma exchange in critically ill children: 18-year experience of a tertiary care paediatric intensive care unit

Ekinci,

Yildizdas,

Horoz

et al. 2024

Australian Critical Care

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Feasibility & safety of plasma exchange in paediatric neuro-immunology: A single center experience

Cited by 5 publications

References 19 publications

Safety and efficacy of plasma exchange treatment in children with AQP4-IgG positive neuromyelitis optica spectrum disorder

Safety and efficacy of plasma exchange treatment in children with AQP4-IgG positive neuromyelitis optica spectrum disorder

Clinical Improvement with Therapeutic Plasma Exchange in Neuroimmunological Children: A Single Center Experience

Therapeutic plasma exchange in critically ill children: 18-year experience of a tertiary care paediatric intensive care unit

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