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Therapeutic plasma exchange

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https://www.readbyqxmd.com/read/29334938/therapeutic-plasma-exchange-in-a-tertiary-care-center-185-patients-undergoing-912-treatments-a-one-year-retrospective-analysis
#1
Julius J Schmidt, Firas Asper, Gunilla Einecke, Gabriele Eden, Carsten Hafer, Jan T Kielstein
BACKGROUND: Therapeutic plasma exchange (TPE) is increasingly used throughout the world. Although the procedure itself is fairly standardized, it is yet unknown how the underlying disease entities influence the key coordinates of the treatment. METHODS: Retrospective chart review. The treatment indications were clustered into four categories. Data are presented as median and interquartile (25-75%) range [IQR]. RESULTS: Within 1 year, 912 TPE treatments were performed in 185 patients (90 female, 48...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334853/therapeutic-plasma-exchange-use-in-pediatric-neurologic-disorders-at-a-tertiary-care-center-a-10-year-review
#2
Sonika Agarwal, Jake R Keller, Chloe E Nunneley, Eyal Muscal, Michael C Braun, Poyyapakkam Srivaths, Timothy E Lotze
Pediatric neurologic conditions requiring therapeutic plasma exchange are rare in children and literature is sparse. The study aims to determine the outcomes, safety, and feasibility of therapeutic plasma exchange treatment in pediatric neurologic disorders. This retrospective analysis looked at the outcomes and safety of therapeutic plasma exchange in children (n = 50) with neurologic conditions. Patient age ranged <1 to 19 years old with a mean of 10.35 years. Of the 50 children treated with plasmapheresis, 26 patients received inpatient rehabilitation...
February 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29321467/importance-of-regular-and-maintenance-therapy-adherence-in-neuromyelitis-optica-nmo-lessons-from-a-repeating-relapse-case
#3
Jing Miao, Doreen E Aboagye, Boris Chulpayev, Lin Liu, Gary Ishkanian, Bangaruraju Kolanuvada, Dariush Alaie, Richard L Petrillo
BACKGROUND Neuromyelitis optica (NMO) is a rare demyelinating disease of the central nervous system; NMO predominantly affects the spinal cord and optic nerves. The diagnosis is based on history, clinical presentation, seropositive NMO-IgG antibody, and notably, exclusion of other diseases. Despite the absence of definitive therapeutic strategies for NMO, methylprednisolone pulse therapy and plasma exchange are used for acute phase treatment, while immunosuppressive agent(s) are recommended to prevent relapses and improve prognosis...
January 11, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29306308/use-of-plasma-exchange-as-therapeutic-tool-in-clinical-practice
#4
Isabel Laura Campano-Pérez, Rosario Olivera-Fernández, Lara González-Freire, Carlos Crespo-Diz
OBJECTIVE: To descrive the use of therapeutic plasma exchange in several pathologies and its adjustment to international reference guides. METHOD: Observational, descriptive, retrospective study, of all the patients that  received plasmapheresis between January 2014-December 2015. We analized  the appropriate indication according to the bibliography consulted, and the  therapeutic outcome. Indication, replaced volume of plasma, number of sessions  and periodicity were established by the Hematology Service depending  on the disease and its clinical course...
January 1, 2018: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/29304523/insights-into-3d-structure-of-adamts13-a-stepping-stone-towards-novel-therapeutic-treatment-of-thrombotic-thrombocytopenic-purpura
#5
Bogac Ercig, Kanin Wichapong, Chris P M Reutelingsperger, Karen Vanhoorelbeke, Jan Voorberg, Gerry A F Nicolaes
ADAMTS13 (A D: isintegrin A: nd M: etalloprotease with a T: hromboS: pondin type-1 motif, member 13: ) and von Willebrand factor (VWF) can be considered as scale weights which control platelet adhesion during primary haemostasis. In a very uncommon condition designated thrombotic thrombocytopenic purpura (TTP), functional absence of ADAMTS13 tips the balance toward VWF-mediated platelet adhesion in the microcirculation. TTP is associated with a high mortality and arises from either a congenital or acquired autoimmune deficiency of the plasma enzyme ADAMTS13...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29259835/efficacy-of-rituximab-in-a-systemic-lupus-erythematosus-patient-presenting-with-diffuse-alveolar-hemorrhage
#6
Gabriela Montes-Rivera, Grissel Ríos, Luis M Vilá
Diffuse alveolar hemorrhage (DAH) is a life-threatening complication of systemic lupus erythematosus (SLE). Although infrequent, its mortality is very high. While there are no established therapeutic guidelines, DAH has been traditionally managed with high-dose intravenous (IV) corticosteroids, cyclophosphamide, and plasma exchange. The efficacy of alternative therapies such as rituximab has been described only in a few cases. Herein, we report a 25-year-old Hispanic man who presented with acute-onset SLE manifested by polyarthralgia, nephritis, seizures, pancytopenia, severe hypocomplementemia, and elevated anti-dsDNA antibodies...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/29250791/successful-management-of-severe-red-blood-cell-alloimmunization-in-pregnancy-with-a-combination-of-therapeutic-plasma-exchange-intravenous-immune-globulin-and-intrauterine-transfusion
#7
Laura C Nwogu, Kenneth J Moise, Kimberly L Klein, Hlaing Tint, Brian Castillo, Yu Bai
BACKGROUND: Antibodies to Rhesus and Kell antigens have been associated with severe hemolytic disease of the fetus and newborn (HDFN) necessitating intrauterine transfusion (IUT) of red blood cells (RBCs). We report a case series of five women with severe HDFN secondary to maternal RBC alloimmunization who were successfully managed with therapeutic plasma exchange (TPE), intravenous immune globulin (IVIG), and IUT. STUDY DESIGN AND METHODS: This is a retrospective case series of five women with severe HDFN who underwent a total of three TPE procedures during Weeks 10 to 13 of pregnancy, followed by weekly IVIG infusions...
December 17, 2017: Transfusion
https://www.readbyqxmd.com/read/29250516/use-of-therapeutic-plasma-exchange-during-extracorporeal-life-support-in-critically-ill-cardiac-children-with-thrombocytopenia-associated-multi-organ-failure
#8
Mei Chong, Alejandro J Lopez-Magallon, Lucas Saenz, Mahesh S Sharma, Andrew D Althouse, Victor O Morell, Ricardo Munoz
Background: Thrombocytopenia-associated multi-organ failure (TAMOF) in children is a well-described factor for increased hospital mortality. Low cardiac output syndrome (LCOS) and the effects of cardiopulmonary bypass may manifest with several adverse physiologic and immunologic effects, with varying degrees of thrombocytopenia and multi-organ dysfunction, sometimes very similar to TAMOF. LCOS is a common occurrence in children with critical heart disease, presenting in as much as 23...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29250459/intrahepatic-cholestasis-of-pregnancy-refractory-to-multiple-medical-therapies-and-plasmapheresis
#9
Adam John Covach, William Nicholas Rose
Objectives  We report on a patient suffering from intractable itching secondary to intrahepatic cholestasis of pregnancy (ICP) unresponsive to conventional medical therapies. She was started on a regimen of therapeutic plasma exchange (TPE), which is often efficacious in relieving patient's itching from all causes of cholestasis, including ICP. Methods  We performed a retrospective review of a patient's medical record. Results  Following initial TPE, the patient reported dramatic relief of her itching and consequent insomnia...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29238515/role-of-therapeutic-plasma-exchange-in-the-treatment-of-severe-hypertriglyceridemia-an-experience
#10
Shaikh Ahmed Muntajib Wassay, Farhan Javed Dar, Asem K Saleh, Ibrahim Mansoor
Hypertriglyceridemia of obesity, the metabolic syndrome, and type II diabetes mellitus are highly prevalent in Saudi Arabia. Severe hypertriglyceridemia is a rare but well known cause of acute pancreatitis. In treatment pancreatic rest, lifestyle changes, and lipid-lowering medications are essential, but the response is slow. Recently the role of therapeutic plasma exchange (TPE) has been stressed for fast and effective management in addition to insulin and heparin infusion. TPE for hypertriglyceridemic pancreatitis resulted in drastic improvements in clinical and laboratory findings and patient outcomes as suggested in our cases...
December 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29238021/-granulomatosis-with-polyangiitis-complicated-with-gastrointestinal-perforation-a-case-report-and-review-of-literature
#11
Takao Kiboshi, Kentaro Isoda, Koichi Furukawa, Tomoyuki Wakahara, Kenichiro Otani, Kayo Ueda, Junichi Konma, Kazuhiro Teramura, Nozomi Ueno, Hiroshi Fujiwara, Takeshi Shoda
  A 51-year-old man was detected nasal bleeding, multiple pulmonary nodule and mass, urinalysis abnormality, renal involvement and high titer of proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), and was suspected of granulomatosis with polyangiitis and initiated with steroid pulse therapy. On the day after the start of steroid pulse therapy, generalized peritonitis due to ileal perforation occurred, and emergency ileectomy and peritonitis surgery were performed. Induction therapy with steroid pulse therapy, plasma exchange and intravenous cyclophosphamide therapy (IVCY) and maintenance therapy with glucocorticoid and azathioprine led to good therapeutic outcomes...
2017: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
https://www.readbyqxmd.com/read/29233194/ibuprofen-plasma-concentration-profile-in-deliberate-ibuprofen-overdose-with-circulatory-depression-treated-with-therapeutic-plasma-exchange-a-case-report
#12
Stefanie Geith, Bertold Renner, Christian Rabe, Jochen Stenzel, Florian Eyer
BACKGROUND: Inquiries relating to ibuprofen overdose have more than tripled in the last ten years in our poison control center. Although the vast majority of cases have a benign clinical course, there are few severe or even fatal cases present with refractory circulatory failure. CASE PRESENTATION: We describe a case of a 48 year-old male with suicidal mono-ingestion of approximately 72 g ibuprofen. Despite an initial rapid spontaneous drop in the total ibuprofen plasma concentration (IPC) from 550 to 275 mcg/mL within the first 5 h after admission, the patient developed a circulatory failure, refractory to aggressive fluid resuscitation and high doses of vasopressors...
December 12, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29226136/a-new-platelet-aggregation-inhibiting-factor-isolated-from-bothrops-moojeni-snake-venom
#13
Bruna Barbosa de Sousa, Carla Cristine Neves Mamede, Mariana Santos Matias, Déborah Fernanda da Cunha Pereira, Mayara Ribeiro de Queiroz, Edigar Henrique Vaz Dias, Anielle Christine Almeida Silva, Noelio Oliveira Dantas, Júnia de Oliveira Costa, Fábio de Oliveira
This work reports the purification and functional characterization of BmooPAi, a platelet-aggregation-inhibiting factor from Bothrops moojeni snake venom. The toxin was purified by a combination of three chromatographic steps (ion-exchange on DEAE-Sephacel, molecular exclusion on Sephadex G-75, and affinity chromatography on HiTrap™ Heparin HP). BmooPAi was found to be a single-chain protein with an apparent molecular mass of 32 kDa on 14% SDS-PAGE, under reducing conditions. Sequencing of BmooPAi by Edman degradation revealed the amino acid sequence LGPDIVPPNELLEVM...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29226117/pediatric-anti-n-methyl-d-aspartate-receptor-encephalitis-a-review-with-pooled-analysis-and-critical-care-emphasis
#14
REVIEW
Kenneth E Remy, Jason W Custer, Joshua Cappell, Cortney B Foster, Nan A Garber, L Kyle Walker, Liliana Simon, Dayanand Bagdure
Purpose: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is being recognized with increasing frequency among children. Given the paucity of evidence to guide the critical care management of these complex patients, we provide a comprehensive review of the literature with pooled analysis of published case reports and case series. Methods: We performed a comprehensive literature search using PubMed, Scopus, EMBASE, and Web of Science for relevant published studies...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29222317/thrombocytopenia-in-hospitalized-patients-approach-to-the-patient-with-thrombotic-microangiopathy
#15
REVIEW
Marie Scully
Thrombotic microangiopathies (TMAs), specifically, thrombotic thrombocytopenic purpura (TTP) and complement-mediated hemolytic uremic syndrome (CM-HUS) are acute life-threatening disorders that require prompt consideration, diagnosis, and treatment to improve the high inherent mortality and morbidity. Presentation is with microangiopathic hemolytic anemia and thrombocytopenia (MAHAT) and variable organ symptoms resulting from microvascular thrombi. Neurological and cardiac involvement is most common in TTP and associated with poorer prognosis and primarily renal involvement in CM-HUS...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222314/plasma-exchange-in-thrombotic-microangiopathies-tmas-other-than-thrombotic-thrombocytopenic-purpura-ttp
#16
REVIEW
Jeffrey L Winters
Thrombotic microangiopathies (TMAs) are a diverse group of disorders that are characterized by common clinical and laboratory features. The most commonly thought-of TMA is thrombotic thrombocytopenic purpura (TTP). Because of the marked improvement in patient mortality associated with the use of therapeutic plasma exchange (TPE) in TTP, this therapy has been applied to all of the TMAs. The issue, however, is that the pathophysiology varies and in many instances may represent a disorder of the endothelium and not the blood; in some cases, the pathophysiology is unknown...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29205892/biological-agents-and-therapeutic-plasma-exchange-can-they-coexist-in-the-future
#17
EDITORIAL
Andreas Kronbichler
No abstract text is available yet for this article.
December 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29197156/identification-of-aggregates-in-therapeutic-formulations-of-recombinant-full-length-factor-viii-products-by-sedimentation-velocity-analytical-ultracentrifugation
#18
J F Healey, E T Parker, P Lollar
BACKGROUND: The development of inhibitory anti-factor VIII (fVIII) antibodies is the most serious complication in the management of patients with hemophilia A. Studies have suggested that recombinant full-length fVIII is more immunogenic than plasma-derived fVIII and that among recombinant fVIII products, Kogenate is more immunogenic than Advate. Aggregates in biopharmaceutical products are considered a risk factor for the development of anti-drug antibodies. OBJECTIVE: To evaluate recombinant full-length fVIII products for the presence of aggregates...
December 2, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29193101/case-series-supporting-heme-detoxification-via-therapeutic-plasma-exchange-in-acute-multiorgan-failure-syndrome-resistant-to-red-blood-cell-exchange-in-sickle-cell-disease
#19
James E Louie, Caitlin J Anderson, Katayoun Fayaz M Fomani, Alonye Henry, Trevor Killeen, Narla Mohandas, Karina Yazdanbakhsh, John D Belcher, Gregory M Vercellotti, Patricia A Shi
BACKGROUND: Depletion of haptoglobin (Hp) and hemopexin (Hx) with increase in free hemoglobin and heme are important etiologies of vaso-occlusive complications in sickle cell disease (SCD). This study is the first to show an association between clinical improvement in SCD and repletion of Hp and Hx by therapeutic plasma exchange (TPE) using plasma replacement. STUDY DESIGN AND METHODS: Thirteen fresh-frozen plasma (FFP) units derived from consecutive whole blood donations were thawed at 37°C after 10 months of storage; Hp and Hx concentrations immediately postthaw and after 5 days of refrigerated storage were analyzed by enzyme-linked immunosorbent assay (ELISA)...
November 27, 2017: Transfusion
https://www.readbyqxmd.com/read/29192644/automated-centrifugal-therapeutic-plasma-exchange-option-for-guillain-barre-syndrome-a-report-from-calabar-nigeria
#20
O E Iheanacho, C Chimeziem, B S Sachais, P A Shi
Therapeutic plasma exchange (TPE) is performed frequently and effectively in developed countries, whereas the reverse is the case in developing countries. Guillain-Barre syndrome (GBS), synonymous with acute inflammatory demyelinating polyneuropathy, is an important indication for TPE, but this is rarely administered in the treatment of such patients in Nigeria due to lack of such automated facility, limited expertise, and high cost. This report therefore presents an uncommon case of GBS in which automated TPE was utilized in the management, with the aims of highlighting the current status and challenges of therapeutic apheresis services in Nigeria...
October 2017: Nigerian Journal of Clinical Practice
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