Plasma-exchange in chronic peripheral neurological disorders

被引:12
作者
Mazzi, G
Raineri, A
Zucco, M
Passadore, P
Pomes, A
Orazi, BM
机构
[1] Azienda Osped S Maria degli Angeli, Serv Immunotrasfusionale, I-33170 Pordenone, Italy
[2] Azienda Osped S Maria degli Angeli, Div Neurol, I-33170 Pordenone, Italy
关键词
therapeutic plasma exchange; chronic peripheral neuropathy; alpha-interferon; monoclonal gammopathy undetermined significance; demyelinating polyneuropathy; mononeuropathy multiplex;
D O I
10.1177/039139889902200109
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
We investigated 19 patients affected by chronic peripheral neurological disorders treated with therapeutic plasma exchange (TPE) to verify the efficacy of the therapeutic protocol used in these diseases. Every patient was clinically considered after 5 TPE. Those who showed an improvement started chemotherapy and continued TPE at the rate of 2 procedures/week for 2 weeks, then 1 procedure/week for 1 month and finally 1 procedure every 2 weeks for 2 months. Intravenous immunoglobulins (IVIg) were infused at the end of apheretic treatment in one of the patients affected by neurological disorders due to monoclonal gammopathy undetermined significance. HCV-positive patients with cryoglobulins were treated with alpha-interferon (alpha-IFN) for 6 months before TPE. Eleven patients (58%) had a symptomatic improvement, 2 (1.5%) stopped TPE treatment owing to side effects and 6 (31.5%) did not respond to apheretic therapy. In order to improve the advantages of TPE we suggest using IVIg at the end of apheretic therapy, while in HCV-positive patients, at least one year of alpha-IFN therapy is required before initiating TPE.
引用
收藏
页码:40 / 46
页数:7
相关论文
共 34 条
[1]   CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY - CLINICAL CHARACTERISTICS, COURSE, AND RECOMMENDATIONS FOR DIAGNOSTIC-CRITERIA [J].
BAROHN, RJ ;
KISSEL, JT ;
WARMOLTS, JR ;
MENDELL, JR .
ARCHIVES OF NEUROLOGY, 1989, 46 (08) :878-884
[2]   ANTI-MAG ANTIBODY-ASSOCIATED POLYNEUROPATHIES - IMPROVEMENT FOLLOWING IMMUNOTHERAPY WITH MONTHLY PLASMA-EXCHANGE AND IV-CYCLOPHOSPHAMIDE [J].
BLUME, G ;
PESTRONK, A ;
GOODNOUGH, LT .
NEUROLOGY, 1995, 45 (08) :1577-1580
[3]  
BOSCH EP, 1993, MED CLIN N AM, V77, P125
[4]  
BOSCH PE, 1991, NEUROLOGY CLIN PRACT, V2, P1719
[5]  
CASATO M, 1991, BLOOD, V78, P3142
[6]  
Ciavarella D, 1993, J Clin Apher, V8, P242, DOI 10.1002/jca.2920080406
[7]  
CORNBLATH DR, 1991, NEUROLOGY, V41, P617
[8]   PERIPHERAL NEUROPATHY AS AN EARLY MARKER OF AL AMYLOIDOSIS [J].
DUSTON, MA ;
SKINNER, M ;
ANDERSON, J ;
COHEN, AS .
ARCHIVES OF INTERNAL MEDICINE, 1989, 149 (02) :358-360
[9]   PLASMA-EXCHANGE IN POLYNEUROPATHY ASSOCIATED WITH MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE [J].
DYCK, PJ ;
LOW, PA ;
WINDEBANK, AJ ;
JARADEH, SS ;
GOSSELIN, S ;
BOURQUE, P ;
SMITH, BE ;
KRATZ, KM ;
KARNES, JL ;
EVANS, BA ;
PINEDA, AA ;
OBRIEN, PC ;
KYLE, RA .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (21) :1482-1486
[10]   PLASMA-EXCHANGE IN CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY [J].
DYCK, PJ ;
DAUBE, J ;
OBRIEN, P ;
PINEDA, A ;
LOW, PA ;
WINDEBANK, AJ ;
SWANSON, C .
NEW ENGLAND JOURNAL OF MEDICINE, 1986, 314 (08) :461-465