Advanced search
1 file | 943.51 KB

Therapeutic plasma exchange in children with acute autoimmune central nervous system disorders

Agnieszka Prytula-Ebels (UGent) , Johan Vande Walle (UGent) , HELENE VERHELST (UGent) , Sunny Eloot (UGent) , Stefaan Claus (UGent) , Annik de Jaeger (UGent) , Jo Dehoorne (UGent) and Ann Raes (UGent)
Author
Organization
Abstract
Background: There is a growing evidence for autoimmunity in acute central nervous system (CNS) disorders and treatment with therapeutic plasma exchange (TPE) may be considered. The aim was to share our experience on the clinical application of TPE in these disorders and to present a reproducible protocol which can be used even in small children. Methods: We present a series of 8 children aged 2-12 years with transverse myelitis, Bickerstaff's brainstem encephalitis, neuromyelitis optica, and acute paraneoplastic or unspecified encephalitis in whom TPE was used as a second-line or rescue treatment. Results: A total of 104 TPE sessions were performed where 80-110 ml/kg of plasma was exchanged using 4% - albumin solution and fresh frozen plasma. Six episodes of TPE-related adverse events were documented. Fibrinogen concentrations decreased after the first TPE, whereas platelets decreased gradually. One patient died in the course of the acute illness. Three children achieved a complete resolution of symptoms, 2 children have mild sequelae; whereas 2 children remain paraplegic after a follow-up of 3 to 17 months. Conclusions: We report 8 children with presumably autoimmune-mediated, acute CNS disorders treated with TPE as a rescue therapy. Although the effect of TPE can only be inferred, 5 children had a good clinical outcome. TPE is feasible even in small children with acute autoimmune CNS disorders.
Keywords
Therapeutic apheresis, Pediatric, Central nervous system, ACUTE DISSEMINATED ENCEPHALOMYELITIS, NEUROMYELITIS-OPTICA, APHERESIS, ENCEPHALITIS, RECEPTOR, ANTIBODIES, COMPLICATIONS, DEMYELINATION, DISEASE, ANTIGEN

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 943.51 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Prytula-Ebels, Agnieszka, Johan Vande Walle, HELENE VERHELST, Sunny Eloot, Stefaan Claus, Annik de Jaeger, Jo Dehoorne, and Ann Raes. 2015. “Therapeutic Plasma Exchange in Children with Acute Autoimmune Central Nervous System Disorders.” International Journal of Artificial Organs 38 (9): 494–500.
APA
Prytula-Ebels, A., Vande Walle, J., VERHELST, H., Eloot, S., Claus, S., de Jaeger, A., Dehoorne, J., et al. (2015). Therapeutic plasma exchange in children with acute autoimmune central nervous system disorders. INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, 38(9), 494–500.
Vancouver
1.
Prytula-Ebels A, Vande Walle J, VERHELST H, Eloot S, Claus S, de Jaeger A, et al. Therapeutic plasma exchange in children with acute autoimmune central nervous system disorders. INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS. 2015;38(9):494–500.
MLA
Prytula-Ebels, Agnieszka, Johan Vande Walle, HELENE VERHELST, et al. “Therapeutic Plasma Exchange in Children with Acute Autoimmune Central Nervous System Disorders.” INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS 38.9 (2015): 494–500. Print.
@article{7057933,
  abstract     = {Background: There is a growing evidence for autoimmunity in acute central nervous system (CNS) disorders and treatment with therapeutic plasma exchange (TPE) may be considered. The aim was to share our experience on the clinical application of TPE in these disorders and to present a reproducible protocol which can be used even in small children. 
Methods: We present a series of 8 children aged 2-12 years with transverse myelitis, Bickerstaff's brainstem encephalitis, neuromyelitis optica, and acute paraneoplastic or unspecified encephalitis in whom TPE was used as a second-line or rescue treatment. 
Results: A total of 104 TPE sessions were performed where 80-110 ml/kg of plasma was exchanged using 4\% - albumin solution and fresh frozen plasma. Six episodes of TPE-related adverse events were documented. Fibrinogen concentrations decreased after the first TPE, whereas platelets decreased gradually. One patient died in the course of the acute illness. Three children achieved a complete resolution of symptoms, 2 children have mild sequelae; whereas 2 children remain paraplegic after a follow-up of 3 to 17 months. 
Conclusions: We report 8 children with presumably autoimmune-mediated, acute CNS disorders treated with TPE as a rescue therapy. Although the effect of TPE can only be inferred, 5 children had a good clinical outcome. TPE is feasible even in small children with acute autoimmune CNS disorders.},
  author       = {Prytula-Ebels, Agnieszka and Vande Walle, Johan and VERHELST, HELENE and Eloot, Sunny and Claus, Stefaan and de Jaeger, Annik and Dehoorne, Jo and Raes, Ann},
  issn         = {0391-3988},
  journal      = {INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS},
  keyword      = {Therapeutic apheresis,Pediatric,Central nervous system,ACUTE DISSEMINATED ENCEPHALOMYELITIS,NEUROMYELITIS-OPTICA,APHERESIS,ENCEPHALITIS,RECEPTOR,ANTIBODIES,COMPLICATIONS,DEMYELINATION,DISEASE,ANTIGEN},
  language     = {eng},
  number       = {9},
  pages        = {494--500},
  title        = {Therapeutic plasma exchange in children with acute autoimmune central nervous system disorders},
  url          = {http://dx.doi.org/10.5301/ijao.5000435},
  volume       = {38},
  year         = {2015},
}

Altmetric
View in Altmetric
Web of Science
Times cited: