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https://www.readbyqxmd.com/read/28939369/selective-plasma-exchange
#1
REVIEW
Atsushi Ohkubo, Tomokazu Okado
Selective plasma exchange (SePE) is a new modality of simple plasma exchange that uses a selective membrane plasma separator Evacure EC-4A10 (EC-4A) (Kawasumi Laboratories Inc., Tokyo, Japan). EC-4A has a relatively small pore size of 0.03μm, which is around one-tenth that of conventional plasma separators. The sieving coefficients of albumin, immunoglobulin G (IgG), factor XIII (FXIII), and fibrinogen using EC-4A have been shown to be 0.73, 0.5, 0.17, and 0, respectively. Therefore, one session of SePE can remove approximately 50% of IgG regardless of the IgG subclasses while retaining coagulation factors, such as FXIII and fibrinogen...
August 30, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28938341/neurological-toxicities-associated-with-immune-checkpoint-inhibitors
#2
Mehdi Touat, Daniel Talmasov, Damien Ricard, Dimitri Psimaras
PURPOSE OF REVIEW: Immune-checkpoint inhibitors (ICIs) constitute a novel class of agents recently approved to treat a number of human malignancies. Due to their immunomodulatory mechanism of action, ICIs can generate a wide range of immune-related adverse events (irAEs) of which neurological toxicities are of special interest because of their potential severity. The objective of this review is to examine the recent literature describing neurological irAEs and discuss their optimal management...
September 21, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28938311/feasibility-of-monotherapy-by-rituximab-without-additional-desensitization-in-abo-incompatible-living-donor-liver-transplantation
#3
Hidekazu Yamamoto, Koshi Uchida, Seiichi Kawabata, Kaori Isono, Kohei Miura, Shintaro Hayashida, Yuki Oya, Yasuhiko Sugawara, Yukihiro Inomata
BACKGROUND: Rituximab is a cornerstone in the regimens of desensitization for ABO-incompatible living donor liver transplantation (ABO-i LT) that makes this modality an acceptable option for liver transplantation. Plasmapheresis (PP) to reduce anti-ABO antibody titer and local infusion therapy (LI) were practiced as the strategies for desensitization before the application of rituximab and were reported as additional treatments. The aim of this study was to clarify the feasibility of monotherapy by rituximab without any additional desensitization treatments in ABO-i LT...
September 20, 2017: Transplantation
https://www.readbyqxmd.com/read/28937063/a-mini-epidemic-of-anti-glomerular-basement-membrane-disease-clinical-and-epidemiological-study
#4
Umesh Lingaraj, Shivaprasad Sasivehalli Mallappa, Rajiv Elkal Neminah, Satishkumar Madakala Mohan, Leelavathi Venkatesh, Sreedhara Chikkanayakanahalli Gurusiddaiah, Niranjan Manibally Rachaiah
Acute glomerulonephritis due to anti-glomerular basement membrane (anti-GBM) antibody disease is rare, estimated to occur in fewer than one case per million population and accounts for less than 20% of rapidly progressive glomerulonephritis. The prevalence among patients evaluated for potential glomerular disease is lower. It accounts for fewer than 3% of all kidney biopsies done with crescentic glomerulonephritis. Cases of anti-GBM disease occurring in a cluster have rarely been reported. All biopsy proven anti-GBM disease cases were collected from January 2015 to March 2015 at our Institute...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28928949/plasmapheresis-in-neurological-disorders-six-years-experience-from-university-clinical-center-tuzla
#5
Osman Sinanović, Sanela Zukić, Adnan Burina, Nermina Pirić, Renata Hodžić, Mirza Atić, Mirna Alečković-Halilović, Enisa Mešić
BACKGROUND: Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique that is designed to remove substances with a large molecular weight. The TPE procedure includes removal of antibodies, alloantibodies, immune complexes, monoclonal protein, toxins or cytokines, and involves the replenishment of a specific plasma factor. The aim of the study was to describe the clinical response to TPE in various neurological patients, and to assess the clinical response to this therapy...
2017: F1000Research
https://www.readbyqxmd.com/read/28927700/the-art-of-separation-and-adsorption-historical-review-of-apheresis-in-japan
#6
REVIEW
Hidenori Matsuo
Apheresis therapy was first introduced into Japan from the United State as plasmapheresis by a centrifuge method. However, the invention of hollow fiber has subsequently lead to a membrane plasma separation. Selective removal of the plasma or cell component has been improved and matured in clinical application. Therapeutic apheresis has progressed and diversified with the development of technology for membrane separation by hollow fiber and adsorption with a physicochemical adsorbent in Japan.
September 5, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28924105/the-successful-application-of-plasmapheresis-in-the-treatment-of-a-patient-with-opsoclonus-and-autoantibodies-to-glutamate-receptor-%C3%AE-2
#7
Kiyotaka Nakamagoe, Seitaro Nohara, Yukitoshi Takahashi, Mao Takiguchi, Rio Kawakami, Tadachika Koganezawa, Akira Tamaoka
Glutamate receptor δ2 (GluRδ2) is expressed in the neuronal postsynaptic densities at the junctions between the Purkinje cells and the parallel fibers. Recent reports have described patients with opsoclonus who possess anti-GluRδ2 antibodies. We report the case of a 53-year-old man with opsoclonus whose cerebrospinal fluid was positive for anti-GluRδ2 antibodies. Electronystagmography revealed abnormal sinusoidal eye movements, which were definitively identified as opsoclonus. The frequency and amplitude of saccadic oscillations diminished after plasmapheresis (PE)...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28923773/plasma-separation-using-a-membrane
#8
REVIEW
Ryuichiro Hirano, Kenichiro Namazuda, Junsuke Suemitsu, Tetsuro Harashima, Noriko Hirata
Plasma separation using a membrane is clinically used as plasmapheresis therapy, such as plasma exchange (PE), double-filtration plasmapheresis (DFPP), or plasma adsorption (PA) modalities. Plasma separation is performed either by centrifugation or by filtration, which involves a permeable hollow fiber membrane. A plasma separator with a hollow fiber membrane was first developed in Japan in the 1980s. It has been used for more than 30 years with continuous technical modifications. Treatment with a membrane-type plasma separator is a safe and well-established modality for many drug-resistant and/or refractory diseases...
August 31, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28918917/leukocytapheresis-in-rheumatoid-arthritis
#9
REVIEW
Toshihiko Hidaka, Yayoi Hashiba, Kazuyoshi Kubo, Yasufumi Kai, Keiichi Maeda
In this article, we discussed leukocytapheresis (LCAP) for rheumatoid arthritis (RA). Recently, a simple and practical on-line continuous LACP system has been developed. It is equipped with a direct hemoperfusion column (Cellsorba(®), Asahikasei Medical Co., Ltd.) packed with fine-diameter polyester fibers, which are commonly used to adsorb white blood cells to prevent a graft-versus-host reaction during blood transfusion. Clinical trials revealed that LCAP is a effective and safe therapy for patients with drug-resistant RA or RA complicated with vasculitis...
August 30, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28917572/double-filtration-plasmapheresis-determination-of-the-optimal-albumin-concentration-in-the-supplementation-fluid
#10
REVIEW
Michio Mineshima
Many kinds of technologies have been introduced and successfully developed for therapeutic apheresis. During the DFPP treatments, the patient's blood volume (BV) often decreases with time due to albumin loss induced by inadequate albumin infusion in a supplementation fluid. We examined the change of BV by a continuous hematocrit (HCT) monitor, CRIT-LINE™, during an in vivo study for nine patients. As a result, albumin loss was fairly occurred in some DFPP treatments. The decrease of patient's BV was induced by an oncotic pressure drop due to albumin loss and often resulted in a blood pressure drop...
August 30, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28912035/specific-removal-of-autoantibodies-by-extracorporeal-immunoadsorption-ameliorates-experimental-autoimmune-myasthenia-gravis
#11
Konstantinos Lazaridis, Ioannis Dalianoudis, Vasiliki Baltatzidi, Socrates J Tzartos
Myasthenia gravis (MG) is caused by autoantibodies, the majority of which target the muscle acetylcholine receptor (AChR). Plasmapheresis and IgG-immunoadsorption are useful therapy options, but are highly non-specific. Antigen-specific immunoadsorption would remove only the pathogenic autoantibodies, reducing the possibility of side effects while maximizing the benefit. We have extensively characterized such adsorbents, but in vivo studies are missing. We used rats with experimental autoimmune MG to perform antigen-specific immunoadsorptions over three weeks, regularly monitoring symptoms and autoantibody titers...
September 6, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28904486/hemolytic-uremic-syndrome-complicating-acute-pancreatitis
#12
Narinder Pal Singh, Neeru P Aggarwal, Hardik R Shah, Laxmi Kant Jha, Anish Kumar
Hemolytic-uremic syndrome (HUS) is characterized by acute kidney injury with hemolytic anemia and thrombocytopenia. It has diverse etiologies, clinical manifestations, and risk factors. Acute pancreatitis as a cause of HUS is rare in adults. We report a case of 32-year-old male who presented with ethanol-induced acute pancreatitis complicated with hemolytic-uremic syndrome managed with hemodialysis and plasmapheresis.
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904434/effect-of-double-filtration-plasmapheresis-on-various-plasma-components-and-patient-safety-a-prospective-observational-cohort-study
#13
K Jagdish, S Jacob, S Varughese, V G David, A Mohapatra, A Valson, K Tulsidas, T Veerasami, S Alexander
Double filtration plasmapheresis (DFPP) was historically used for blood group incompatible renal transplantation. Very few studies are available worldwide regarding its efficiency in removing specific plasma components, and safety. We conducted a prospective observational cohort study over 1 year on patients undergoing DFPP for various renal indications. There were 15 patients with 39 sessions. The pre- and post-procedure plasma samples of serum IgG, IgA, IgM, fibrinogen, calcium, phosphate, potassium, and magnesium were analyzed...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28895297/changing-trends-in-therapeutic-plasmapheresis-an-indian-perspective
#14
Aseem K Tiwari, Gunjan Bhardwaj, Geet Aggarwal, Dinesh Arora, Ravi C Dara, Devi P Acharya, Sangeetha Gayam, Jui Choudhuri
Indications for therapeutic apheresis (TA) are dynamic; they keep changing and expanding because of introduction of newer treatment modalities and accumulating evidence in the form of case-reports, case-series and original articles. We evaluated our therapeutic plasmapheresis (TP) data and compared this data with an earlier published Indian report for indications, frequency, response rate and adverse reactions. We conducted a retrospective analysis of all TP procedures performed from January 2014 to June 2016 in department of Transfusion Medicine at a tertiary care hospital...
September 11, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28894082/chronic-inflammatory-demyelinating-polyneuropathy-cidp-an-uncommon-manifestation-of-systemic-lupus-erythematosus-sle
#15
Hrudya Abraham, Jose Kuzhively, Syed W Rizvi
BACKGROUND Chronic inflammatory demyelinating polyneuropathy (CIDP) is an uncommon manifestation of systemic lupus erythematosus (SLE). We report a case of SLE presenting as CIDP and discuss the diagnosis, management, and prognosis of CIDP. CASE REPORT A 40-year-old woman with a past medical history of SLE treated with hydroxychloroquine presented with bilateral, progressive, ascending, sensory and motor neuropathy. Physical examination showed weakness and reduced temperature of all extremities, reduced pinprick and vibration sense of the distal extremities, loss of reflexes, and walking with a wide-based unsteady gait...
September 12, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28892919/plasma-exchange-as-a-therapeutic-modality-in-a-rare-case-of-cryptogenic-new-onset-refractory-status-epilepticus-norse
#16
Manisha Shrivastava, Smita Chouhan, Seema Navaid
Refractory Status Epilepticus (RSE) not responding to any therapy and not associated with any aetiology has been termed as New Onset Refractory Status Epilepticus (NORSE). Guidelines for optimal management of cryptogenic NORSE are not clearly defined so far in the literature. Other than common medication, use of high-dose steroids, IV immune globulins and plasma exchanges in NORSE of unknown aetiology have been scarcely described. Immunomodulatory therapy like plasmapheresis is based on the fact that a pathological substance exists in the plasma that contributes to the disease process and its symptoms, which gets removed...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890837/why-it-is-not-always-anxiety-a-tough-diagnosis-of-stiff-person-syndrome
#17
Carmen Elena Cervantes, Hsien Lee Lau, Tina Ataian Binazir, Keith O O'Brien, Jonathan S Cross
Anxiety disorder is a commonly used diagnosis that may mask underlying conditions. Stiff person syndrome (SPS) is a rare neuroimmunological disorder characterized by progressive rigidity and painful muscle spasms affecting axial and lower extremity musculature. These episodes can be triggered by sudden movement, noise, or emotional stress, which may present as a psychiatric condition. We report the case of a 30-year-old female who presented with recurrent panic attacks with multiple prior hospital admissions for anxiety, rigidity, and difficulty in walking...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28890042/guillain-barre-syndrome-in-the-elderly-experience-from-a-tertiary-care-hospital-in-india
#18
M Nagappa, W Rahul, S Sinha, P S Bindu, P S Mathuranath, S Rao, S Periyavan, G S Umamaheshwara Rao, A B Taly
Age influences incidence and prognosis of Guillain Barre Syndrome (GBS), common cause of ascending areflexic quadriparesis. Dedicated studies on elderly GBS are infrequent. This study aimed to describe clinical features and outcome at hospital-discharge in patients aged≥60years with GBS. Medical records of 70 elderly GBS over 15years were analysed. Mean symptom-duration was 5.78±4.5days and onset-to-peak 5.14±4.4days. Antecedent events preceded GBS by 8.07±9.9days and included: fever (n=19), respiratory infection (n=6), and gastroenteritis (n=5)...
September 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#19
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28866833/voriconazole-induced-periostitis-deformans-serial-imaging-in-a-patient-with-anca-vasculitis
#20
S Cormican, N Adams, P O'Connell, A McErlean, D de Freitas
OBJECTIVES: A 61-year-old with acute granulomatosis and polyangiitis developed Aspergillus fumigatus pneumonia after admission to the intensive care unit with a small bowel perforation. This occurred after immunosuppression (intravenous methylprednisolone, intravenous cyclophosphamide, and plasmapheresis) for his initial presentation with stage 3 acute kidney injury. MATERIALS AND METHODS: The mycologist recommended long-term treatment with voriconazole after initial recovery...
September 2, 2017: Skeletal Radiology
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