Apheresis in treatment of acute inflammatory demyelinating disorders. (May 2015)

• Record Type: Journal Article
• Authors: Mühlhausen, Johannes; Kitze, Bernd; Huppke, Peter; Müller, Gerhard A.; Koziolek, Michael J.
• Is Part Of: Atherosclerosis. Volume 18(2015)
• Page Start: 251
• Page End: 256
• Publication Date: 2015-05
• Subjects: Acute disseminated encephalomyelitis -- Children -- Immunoadsorption -- Multiple sclerosis -- Neuromyelitis optica -- Pediatric -- Plasmapheresis; ADEM acute disseminated encephalomyelitis -- CIS clinical isolated syndrome -- EDSS expanded disability status scale -- IA immunoadsorption -- MS multiple sclerosis -- NMO neuromyelitis optica -- PE plasma exchange -- PP/SPMS primary/secondary progredient MS -- RRMS relapsing remitting MS; Atherosclerosis -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Periodicals; 616.136
• DOI: 10.1016/j.atherosclerosissup.2015.02.037
• Languages: English
• ISSNs: 1567-5688

Abstract

Abstract: Therapeutic apheresis has reached an important value in the treatment of neurologic disorders. In the indication of acute relapses of inflammatory demyelinating conditions plasma exchange (PE) is currently mentioned in guidelines in adults and children. Immunoadsorption (IA) is a younger but more selective apheresis method. Compared to PE, data on IA in these indications are less substantiated. Hitherto existing studies indicate IA as effective and safe with similar response rates versus PE. Our own study of 140 adult patients treated with PE or IA in steroid refractory multiple sclerosis or neuromyelitis optica affirm previous findings showing no significant difference in efficacy and treatment safety. Analogue to adult patients, children seem to benefit from apheresis therapy in steroid resistant inflammatory demyelinating conditions but their treatment implies certain challenges concerning physiology, anatomy and psychological aspects necessitating a multidisciplinary therapeutic setting.