Limited plasmapheresis in rheumatoid arthritis with vasculitis

Goldman, John A.; Casey, Helen; McIlwain, Harris H.; Kirby, J.F.; Wilson, Colon H.; Miller, Steven B.

doi:10.1002/art.1780221019

Cited by 60 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been shown in animal studies that removal of specific alloantibodies results in a loss of feedback control resulting in a rebound to levels higher than those present preplasmapheresis (9). A comparable rebound has been noted in humans with various diseases (10,23,24) as well as in patients with rheumatoid arthritis and CIC (25).…”

Section: Discussionmentioning

confidence: 77%

Plasmapheresis in systemic lupus erythematosus. a cautionary note

Schlansky

DeHoratius

Pincus

et al. 1981

Arthritis & Rheumatism

View full text Add to dashboard Cite

Plasmapheresis was used as the sole treatment modality in 4 patients with systemic lupus erythematosus. The presence of circulating immune complexes in this group of patients was not predictive of response to plasmapheresis. Lymphocytotoxic antibody levels fell in 3 of the 4 patients, and no consistent changes in T lymphocytes, T lymphocyte subsets, complement, or immunoglobulin levels were observed. Followup during the subsequent 6 months showed deterioration in clinical and laboratory parameters in all 4 patients, and the protocol was discontinued. Plasmapheresis without concomitant therapy may be detrimental to certain patients with systemic lupus erythematosus.Plasmapheresis has been described as valuable in the treatment of several immunologically mediated diseases ( 1-6), including systemic lupus erythematosus (SLE), in which the presence of circulating immune complexes (CIC) has been proposed to be predictive of a favorable response to plasmapheresis (5,6). However,

show abstract

Section: Discussionmentioning

confidence: 77%

Plasmapheresis in systemic lupus erythematosus. a cautionary note

Schlansky

DeHoratius

Pincus

et al. 1981

Arthritis & Rheumatism

View full text Add to dashboard Cite

show abstract

“…given because of the neutropenia. However, Plasma exchange has been successfully employed in the treatment of several im mune complex disease [1] and may represent an alternative approach to rheumatoid vas culitis [15]. In particular, this technique has the advantage of rapidly reducing several immunologically related factors, including both autoantibodies and immune complexes [23], In the 2 patients described in this re port, plasma exchange produced an early symptomatic improvement.…”

Section: Resultsmentioning

confidence: 94%

Plasma Exchange in Rheumatoid Vasculitis

Brubaker¹,

Winkelstein²

1981

Vox Sanguinis

View full text Add to dashboard Cite

Vasculitis is an uncommon, extremely debilitating complication of severe, chronic rheumatoid arthritis. High levels of circulating immune complexes along with vascular deposition of immunoglobulins and complement indicate an immune complex mediated disease. No pharmacologic therapy has been completely effective and the incidence of mortality is exceptionally high. This study shows clinical improvement with combination of plasma exchange and cytoxan therapy. We report an association in the conspicuous decline of immune complexes with objective clinical remission in 2 patients who underwent combination therapy. This adjunctive combination therapeutic modality is recommended in the treatment of rheumatoid vasculitis.

show abstract

“…Goldman et al [8] reported on the use of plasmapheresis in treating four patients with severe vasculitis associated with rheumatoid arthritis. They observed a decrease in the rheumatoid factor in all four and clinical improvement in the rheumatoid vasculitis of two of their patients after plasmapheresis; one of the responders died of a myocardial infarction 1 year after apheresis.…”

Section: Review Of Available Informationmentioning

confidence: 98%

“…Because the two patients who had responded were continued on their prednisone and penicillamine therapy, their clinical improvement could not be attributed to plasmapheresis alone. The rapid control of the vasculitis suggested that plasmapheresis contributed to their earlier stabilization [8].…”

Section: Review Of Available Informationmentioning

confidence: 99%

National center for health care technology assessment of therapeutic apheresis for rheumatoid arthritis, 1981

Heyse

Renault

Perry

1982

J of Clinical Apheresis

View full text Add to dashboard Cite

The National Center for Health Care Technology coordinated the Public Health Service's assessment of therapeutic apheresis for rheumatoid arthritis in response to the Health Care Financing Administration's request for advice regarding Medicare coverage of this rapidly emerging technology. The information considered included reports available in the medical literature (as of early 1981), advice from the National Institutes of Health and Food and Drug Administration, advice from the appropriate medical societies, as well as information submitted by interested parties in response to a notice published in the Federal Register announcing the assessment. Synthesis of this information provided the basis for concluding that therapeutic apheresis for rheumatoid arthritis was considered experimental with the possible exception of treatment for life-threatening complications such as vasculitis, cryoglobulinemia, or hyperviscosity syndrome.

show abstract

Limited plasmapheresis in rheumatoid arthritis with vasculitis

Cited by 60 publications

References 13 publications

Plasmapheresis in systemic lupus erythematosus. a cautionary note

Plasmapheresis in systemic lupus erythematosus. a cautionary note

Plasma Exchange in Rheumatoid Vasculitis

National center for health care technology assessment of therapeutic apheresis for rheumatoid arthritis, 1981

Contact Info

Product

Resources

About