Successful Treatment by Plasma Exchange in Guillain-Barré Syndrome with Immune Complexes

et al. 1981

Self Cite

Small volume plasma exchange (PE) was evaluated in 6 patients with acute Guillain-Barré syndrome (GBS) and in 1 with its chronic relapsing type. Patients were treated during the onset or progression of their neurologic involvement and no other combined therapy was provided. 6 of our patients had clear benefit following the first session. Two procedures on alternate days were carried out in 4 patients while a third procedure was performed in 3 due to insufficient exchange or to equivocal improvement. After PE, patients showed moderate to marked improvement in motor strength, in their ventilatory function and in their sensory symptoms, which improved definitely but more slowly than motility. Each patient showed, prior to therapy, high levels of immune complexes; their level was clearly reduced by PE and clinical results correlated with this removal. No relapse was observed during 5-15 months of appropriate follow-up.

Section: Clinical Assessmentmentioning

confidence: 99%

Section: Clinical Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Plasma Exchange as a Therapy for Guillain-Barré Syndrome with Immune Complexes

Valbonesi¹,

Garelli²,

et al. 1981

Self Cite

“…Plasmapheresis was performed by discontinuous flow centrifugation, as previously described [9]; only 5 sessions were carried out by a manual technique. The volume of plasma removed was replaced by Haemaccel (Hoechst) and fresh frozen plasma.…”

Section: Methodsmentioning

confidence: 99%

Plasma Exchange in the Management of Patients with Multiple Sclerosis: Preliminary Observations

Valbonesi¹,

Garelli²,

et al. 1981

Self Cite

Since humoral factors have been implicated in the pathogenesis of multiple sclerosis (MS) and previous attempts at therapeutic intervention have not met with uniform success, plasma exchange (PE) was recently proposed for the management of this disease. We are currently investigating the possible effectiveness of PE in the treatment of MS, and to date 6 patients have been entered into the study. At least 4 of our patients who did not respond to conventional therapy have shown unequivocal, moderate to marked improvement following the first session of PE. At the time of treatment, these patients had an acute exacerbation of their disease. We found no correlation between clinical improvement and the serum immune complex levels, suggesting that other poorly known mechanisms were operative. Based on our preliminary results, we feel that PE may be efficacious in treating exacerbations of MS. More evidence is needed on the effects of PE in the chronic stage of the disease.

“…PE was performed as previously described [13]: in 3 of 10 procedures, a two-vein technique could be used, but we were then forced to modify the exchange technique since only a single vein was available. At all sessions, 700 ml of the patient's plasma were first exchanged with 600 ml Plasmagel (Hoechst), whereas human group A fresh frozen plasma was used to complete the exchange.…”

Section: Apheretic Methodsmentioning

confidence: 99%

Plasma Exchange in the Management of a Patient with Diffuse Necrotizing Cutaneous Vasculitis

Valbonesi¹,

Garelli²,

et al. 1980

Self Cite

It has been sufficiently established that the so-called small vessel vasculitis results from hypersensitivity reactions to various endogenous or exogenous antigens, and that, in most cases, the pathogenic mechanism is the deposition of immune complexes in the blood vessel wall. Among the therapeutic protocols that have been applied recently, plasma exchange (PE) received little attention, and only a few cases have been treated accordingly until now. Here, we present a patient with diffuse cutaneous necrotizing vasculitis, in whom PE proved to be of irreplaceable benefit in halting the progression of the disease. When PE was discontinued, the disease relapsed in spite of therapy with steroids and heparin. A second series of PE again controlled the disease activity. The authors point out that PE was of unique value pending the effects of treatment with cyclophosphamide, which remains the essential therapeutic agent.