Plasma Exchange in Stiff‐Man Syndrome

Shariatmadar, Sherry; Noto, Thomas A.

doi:10.1046/j.1526-0968.2001.005001064.x

Cited by 25 publications

(18 citation statements)

References 15 publications

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“…In other cases, such as stiff-man syndrome, several case reports exist (with at most two patients in any given report), indicating TPE was not effective for antibody negative cases [17][18][19][20]. An ongoing clinical trial was alluded to in a 1999 review [21], but to our knowledge has not been published to date.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic plasma exchange as a nephrological procedure: A single-center experience

et al. 2005

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In the United States, therapeutic plasma exchange (TPE) is both performed and requested by a wide range of services, often on an empiric basis (before a diagnosis is established). Whether empiric therapy is beneficial has not been established. Patients were identified from an electronic procedure log that included those patients who received plasmapheresis at Walter Reed Army Medical Center from 1996 to 2003. The clinical indications, referring service, and outcomes (including deaths) that occurred were tabulated. Between March 1997 and August 2003, 568 TPE treatments were performed in 54 patients. The majority of the diagnoses were either neurologic (48%) or hematologic (37%). Thirty-three patients (61%) received TPE for a Category I indication. Twelve cases were performed empirically (without an established diagnosis) at the request of the referring service, most (7) performed for presumed thrombotic thrombocytopenic purpura (TTP). Almost 80% of patients required central venous catheters for treatment. Twelve patients (22%) experienced a major complication including death, and six patients (11%) died. Of the patients who died, 5 (83%) were treated empirically versus one death (17%) among patients not treated empirically, P < 0.001 by Chi Square. Only one of the seven patients treated empirically for TTP died, however. In logistic regression analysis, empiric treatment was the only factor independently associated with death, adjusted odds ratio, 34.2, 95% CI, 3.4, 334.8, P = 0.003. The most common indication for TPE was neurological disease, which also accounted for the highest proportion of complications. With the exception of presumed TTP, performing TPE in the absence of a confirmed diagnosis was not beneficial.

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Section: Discussionmentioning

confidence: 99%

Therapeutic plasma exchange as a nephrological procedure: A single-center experience

et al. 2005

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“…A five-treatment series administered every other day is considered a standard regimen for autoimmune diseases, but longer and shorter regimens have also been used. [1314]…”

Section: Case Reportmentioning

confidence: 99%

Forty-year-old diabetic lady with tightness in lower limbs

Khade

Deshmukh

Dhonde

et al. 2012

Ann Indian Acad Neurol

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“…In other cases, a benefit from PE was described in several uncontrolled reports. 35 In Japanese patients with myelitis and atopic diathesis, a retrospective study analyzed the therapeutic efficacy of PE versus IVIG application in a four-arm setting. 36 Although slightly limited by low patient numbers, this study suggests an enhanced efficacy in both groups, including PE, to the therapeutic regimen.…”

Section: Plasma Exchange In Multiple Sclerosis Relapsesmentioning

confidence: 99%

Plasmapheresis for neuroinflammatory disorders

Schröder

Linker

Gold

2010

Clinical & Exp Neuroim

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Nowadays, therapeutic plasma exchange (PE) is the most common apheresis procedure. Plasma is separated from corpuscular blood constitutents and replaced with a substitution fluid. Thus, PE is a non‐specific treatment modality. Its therapeutic effect is based on the removal of circulating, pathogenic immune factors, including autoantibodies. To date, PE is well established for several immune mediated neurological disorders. Whilst the first experience was acquired in acute life‐threatening conditions, such as the treatment of Guillain–Barré syndrome or myasthenic crisis, therapeutic success was later achieved in other chronic autoimmune diseases; PE was applied successfully in chronic inflammatory demyelinating polyneuropathy, paraproteinaemic polyneuropathy, stiff‐person syndrome and might also be tried in autoimmune diseases of paraneoplastic origin. From a novel aspect, PE was also established as an escalation therapy for steroid unresponsive relapses of multiple sclerosis, and thus has gained even more widespread attention. Humoral disease mechanisms dominate even more in neuromyelitis optica, as a subtype of MS, and usually respond to PE. Adding to its increasing application in clinical practice, the procedure is usually well tolerated. Possible adverse reactions of PE arise from the large‐size vascular access site, the use of replacement fluids and the need for anticoagulation. (Clin. Exp. Neuroimmunol. doi: 10.1111/j.1759‐1961.2010.0010.x, 2010)

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Plasma Exchange in Stiff‐Man Syndrome

Cited by 25 publications

References 15 publications

Therapeutic plasma exchange as a nephrological procedure: A single-center experience

Therapeutic plasma exchange as a nephrological procedure: A single-center experience

Forty-year-old diabetic lady with tightness in lower limbs

Plasmapheresis for neuroinflammatory disorders

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