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Therapeutic plasma exchange

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https://www.readbyqxmd.com/read/28228838/a-rare-case-of-bilateral-optic-neuritis-and-guillain-barr%C3%A3-syndrome-post-mycoplasma-pneumoniae-infection
#1
Aravindhan Baheerathan, Amy Ross Russell, Fion Bremner, Simon F Farmer
Neurological complications are the most commonly encountered extra-pulmonary manifestation of infection with Mycoplasma pneumoniae (M. pneumoniae). Here the authors report the case of a 39-year-old woman who was admitted with acute-onset bilateral visual loss coinciding with ascending numbness. Clinical examination, neurological imaging, and nerve conduction studies revealed a syndrome of bilateral optic neuritis and Guillain-Barré syndrome (GBS). Serological testing confirmed recent exposure to M. pneumoniae...
February 2017: Neuro-ophthalmology
https://www.readbyqxmd.com/read/28222319/survey-of-the-diagnostic-and-therapeutic-approach-to-new-onset-refractory-status-epilepticus
#2
Christian M Cabrera Kang, Nicolas Gaspard, Suzette M LaRoche, Brandon Foreman
PURPOSE: We conducted a survey of providers to assess for practice patterns in diagnosing and treating new-onset refractory status epilepticus (NORSE). NORSE is the occurrence of prolonged seizures that are not responsive to initial therapies in otherwise healthy individuals without obvious cause on initial presentation. This entity is thought to have multiple etiologies, including autoimmune. METHOD: A 29-question electronic survey was sent to providers included in the Neurocritical Care Society emailing list...
February 9, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28203563/unsuccessful-treatment-with-abatacept-in-recurrent-focal-segmental-glomerulosclerosis-after-kidney-transplantation
#3
Tilde Kristensen, Per Ivarsen, Johan Vestergaard Povlsen
Recurrence of focal segmental glomerulosclerosis (FSGS) after renal transplantation occurs in up to 20-50% of FSGS patients and is associated with inferior allograft survival. Treatment of both primary FSGS as well as recurrent FSGS after transplantation with plasma exchange and immunosuppression is often unsuccessful and remains a major challenge as the disease still leads to end-stage renal disease and decreased graft survival. Previous case reports have described patients with recurrent FSGS who were successfully treated with a B7-1 inhibitor (abatacept) inducing partial or complete remission...
January 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28194065/adverse-events-during-apheresis-procedures-audit-at-a-tertiary-hospital
#4
Kanchan Dogra, Parag Fulzele, Diptiranjan Rout, Rahul Chaurasia, Poonam Coshic, Kabita Chatterjee
Apheretic platelets are better quality blood components which reduce donor exposure and chances of TTIs to transfusion recipients when compared to the whole blood derived components. Though safe, these apheretic donations are associated with donor adverse events. We evaluated the incidence of such adverse events associated with the modern apheresis procedures that would provide an insight as well as help formulating preventive steps to avoid frequent occurrences of such events. This prospective audit-based observational study was conducted over 1 year...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28194064/therapeutic-plasma-exchange-in-patients-with-neurologic-disorders-review-of-63-cases
#5
Anil Tombak, Mehmet Ali Uçar, Aydan Akdeniz, Arda Yilmaz, Hakan Kaleagası, Mehmet Ali Sungur, Eyup Naci Tiftik
Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barrè syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1)...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28188006/changes-in-hemostasis-caused-by-different-replacement-fluids-and-outcome-in-therapeutic-plasma-exchange-in-pediatric-patients-in-a-retrospective-single-center-study
#6
REVIEW
Volker Witt, Herbert Pichler, Elisabeth Beiglboeck, Friedrich Kursten, Lisa Weidner
BACKGROUND: Therapeutic plasma exchange (TPE) is a generally accepted and frequently performed procedure for numerous therapeutic indications in adults. Slowly, TPE is also becoming more and more popular in the treatment of pediatric patients. Although, we know that TPE is safe in pediatric patients, the outcome of children treated with TPE is rarely reported. Furthermore, there are only general recommendations regarding the plasma replacement fluid for children and these are adopted from adults...
January 19, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28183359/unexpected-extrapyramidal-symptoms-and-pulmonary-aspergillosis-in-exertional-heatstroke-with-fulminant-liver-failure-a-case-report
#7
Jie Jiao, Feihu Zhou, Hongjun Kang, Chao Liu, Mengmeng Yang, Jie Hu
BACKGROUND: Exertional heatstroke is a life-threatening condition with high mortality because of the rapid progress of multiple organ dysfunction syndrome even if aggressive treatments are initiated rapidly. Mild to moderate hepatic injury is common in exertional heatstroke, while fulminant liver failure is rare. Extrapyramidal symptoms and pulmonary aspergillosis secondary to liver failure induced by exertional heatstroke have never been reported in prior cases. CASE PRESENTATION: A 25-year-old Han Chinese man presented with exertional heatstroke with fulminant liver failure, subsequent pulmonary aspergillosis, and extrapyramidal symptoms...
February 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28163240/cardiomyopathy-an-approach-to-the-autoimmune-background
#8
REVIEW
Niels-Peter Becker, Johannes Müller, Gerd Wallukat, Ingolf Schimke
Autoimmunity is increasingly accepted as the origin or amplifier of various diseases. In contrast to classic autoantibodies (AABs), which induce immune responses resulting in the destruction of the affected tissue, an additional class of AABs is directed against G-protein-coupled receptors (GPCRs; GPCR-AABs). GPCR-AABs functionally affect their related GPCRs for activation of receptor mediated signal cascades. Diseases which are characterized by the presence of GPCR-AABs with evidence for disease-specific pathogenic activity could be named "functional autoantibody disease"...
February 2, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28159509/human-pericardial-fluid-contains-exosomes-enriched-with-cardiovascular-expressed-micrornas-and-promotes-therapeutic-angiogenesis
#9
Cristina Beltrami, Marie Besnier, Saran Shantikumar, Andrew I U Shearn, Cha Rajakaruna, Abas Laftah, Fausto Sessa, Gaia Spinetti, Enrico Petretto, Gianni D Angelini, Costanza Emanueli
The pericardial fluid (PF) is contained in the pericardial sac surrounding the heart. MicroRNA (miRNA) exchange via exosomes (endogenous nanoparticles) contributes to cell-to-cell communication. We investigated the hypotheses that the PF is enriched with miRNAs secreted by the heart and that it mediates vascular responses through exosome exchange of miRNAs. The study was developed using leftover material from aortic valve surgery. We found that in comparison with peripheral plasma, the PF contains exosomes enriched with miRNAs co-expressed in patients' myocardium and vasculature...
February 1, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28149527/high-performance-of-a-unique-mesoporous-polystyrene-based-adsorbent-for-blood-purification
#10
Jian Chen, Wenyan Han, Jie Chen, Wenhui Zong, Weichao Wang, Yue Wang, Guanghui Cheng, Chunran Li, Lailiang Ou, Yaoting Yu
A multi-functional polystyrene based adsorbent (NKU-9) with a unique mesoporous and a high surface area was prepared by suspension polymerization for removal of therapeutic toxins in blood purification. The adsorbent produced had an almost equal amount of mesopore distribution in the range from 2 to 50 nm. The adsorption of serum toxins with different molecular weights were examined by in vitro adsorption assays and compared with some clinical currently used adsorbents such as HA-330, Cytosorb and BL-300 which are produced by China, America and Japan, respectively...
February 2017: Regenerative Biomaterials
https://www.readbyqxmd.com/read/28110841/treatment-of-autoimmune-thrombotic-thrombocytopenic-purpura-in-the-more-severe-forms
#11
REVIEW
Paul Coppo
Daily therapeutic plasma exchange (TPE) transformed the historically fatal prognosis of acquired, anti-ADAMTS13 antibody-mediated thrombotic thrombocytopenic purpura (TTP), leading to the current overall survival rates of >80%. However, relapses occur in up to 40% of patients and refractory disease with fatal outcomes still occurs. In this context, the introduction of rituximab has probably been the second major breakthrough in TTP management. Rituximab is now routinely recommended during the acute phase, typically in patients with a suboptimal response to treatment, or even as frontline therapy, with high response rates...
December 30, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28101360/successful-treatment-of-anti-nmda-receptor-encephalitis-with-a-prompt-ovarian-tumour-removal-and-prolonged-course-of-plasmapheresis-a-case-report
#12
Elzbieta Rypulak, Michal Borys, Pawel Piwowarczyk, Magdalena Fijalkowska, Beata Potrec, Justyna Sysiak, Janusz Spustek, Alicja Bartkowska-Sniatkowska, Jan Kotarski, Waldemar A Turski, Konrad Rejdak, Miroslaw Czuczwar
Anti-N-methyl-d-aspartate-receptor (NMDAR) encephalitis is an uncommon autoimmune disorder with a wide spectrum of neuropsychiatric symptoms. There is a great requirement to emphasize the importance of a multidisciplinary team approach in the process of diagnosis and treatment of the potentially fatal condition, including psychiatrists, neurologists, gynaecologists and intensivists. Physicians must be aware that psychiatric and neurological disorders, which are typical features for NMDAR encephalitis in young women with ovarian tumours, may progress into status epilepticus and respiratory insufficiency...
December 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28099525/polyethylene-glycol-camouflaged-earthworm-hemoglobin
#13
Vivek P Jani, Alborz Jelvani, Selamawit Moges, Parimala Nacharaju, Camille Roche, David Dantsker, Andre Palmer, Joel M Friedman, Pedro Cabrales
Nearly 21 million components of blood and whole blood and transfused annually in the United States, while on average only 13.6 million units of blood are donated. As the demand for Red Blood Cells (RBCs) continues to increase due to the aging population, this deficit will be more significant. Despite decades of research to develop hemoglobin (Hb) based oxygen (O2) carriers (HBOCs) as RBC substitutes, there are no products approved for clinical use. Lumbricus terrestris erythrocruorin (LtEc) is the large acellular O2 carrying protein complex found in the earthworm Lumbricus terrestris...
2017: PloS One
https://www.readbyqxmd.com/read/28096987/therapeutic-plasma-exchange-a-second-line-treatment-for-brodifacoum-poisoning-following-an-anaphylactoid-reaction-to-vitamin-k
#14
Ying Deng, Li Qiu
Vitamin K1 is the first-line therapy to brodifacoum poisoning. Anaphylactoid reactions may occur anytime during intravenous administration of vitamin K1 injection. Vitamin K1 must be ceased when anaphylactoid reactions emerge, and therapeutic plasma exchange could be a second-line option.
January 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28078733/therapeutic-apheresis-in-immunologic-renal-and-neurological-diseases
#15
REVIEW
Rolf Bambauer, Reinhard Latza, Daniel Burgard, Ralf Schiel
Since the mid 1970s, when membrane modules became available, plasma separation techniques have gained in importance especially in the past few years. The advantages of this method are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate and higher efficacy. Systemic autoimmune diseases based on an immune pathogenesis produce autoantibodies and circulating immune complexes, which cause inflammation in the tissues of various organs. In most cases, these diseases have a poor prognosis without treatment...
February 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28062909/paediatric-anti-neutrophil-cytoplasmic-antibody-anca-associated-vasculitis-an-update-on-renal-management
#16
REVIEW
Lucy A Plumb, Louise Oni, Stephen D Marks, Kjell Tullus
The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of disorders characterized by necrotizing inflammation of the small to medium vessels in association with autoantibodies against the cytoplasmic region of the neutrophil. Included in this definition are granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome). AAV are chronic, often relapsing diseases that can be organ or life threatening...
January 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28040331/therapeutic-plasma-exchange-in-rheumatic-diseases-a-university-hospital-experience
#17
Juan Pablo Córdoba, Carolina Larrarte, Cristina Estrada, Daniel G Fernández-Ávila
INTRODUCTION: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting (?). METHODS: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013...
December 16, 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28036320/case-report-of-severe-antithrombin-deficiency-during-extracorporeal-membrane-oxygenation-and-therapeutic-plasma-exchange-for-double-lung-transplantation
#18
Brittney Williams, Michael A Mazzeffi, Pablo G Sanchez, Si M Pham, Zachary Kon, Kenichi A Tanaka
Acquired antithrombin (AT) deficiency is not uncommon in cardiothoracic surgery because of heparin exposure and dilutional or consumptive losses. We report a case of acquired AT deficiency and resultant multiple deep vein thrombosis in a patient with pulmonary fibrosis on veno-venous extracorporeal membrane oxygenation who underwent double lung transplantation with intraoperative therapeutic plasma exchange (TPE) as a part of an immunomodulation regimen for allosensitization. Preoperative heparin anticoagulation resulted in AT deficiency, which was further exacerbated by TPE using albumin...
January 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28003505/bortezomib-for-treatment-of-therapy-refractory-anti-nmda-receptor-encephalitis
#19
Franziska Scheibe, Harald Prüss, Annerose M Mengel, Siegfried Kohler, Astrid Nümann, Martin Köhnlein, Klemens Ruprecht, Tobias Alexander, Falk Hiepe, Andreas Meisel
OBJECTIVE: We assessed the therapeutic potential of the plasma-cell-depleting proteasome inhibitor bortezomib in severe and therapy-refractory cases of anti-NMDA receptor (anti-NMDAR) encephalitis. METHODS: Five severely affected patients with anti-NMDAR encephalitis with delayed treatment response or resistance to standard immunosuppressive and B-cell-depleting drugs (corticosteroids, IV immunoglobulins, plasma exchange, immunoadsorption, rituximab, cyclophosphamide) who required medical treatment and artificial ventilation on intensive care units were treated with 1-6 cycles of 1...
January 24, 2017: Neurology
https://www.readbyqxmd.com/read/27998645/thrombotic-microangiopathy-associated-with-monoclonal-gammopathy
#20
Aishwarya Ravindran, Ronald S Go, Fernando C Fervenza, Sanjeev Sethi
Thrombotic microangiopathy (TMA) is a rare disease comprising of a diverse set of disorders linked by a common histologic finding of endothelial injury. Monoclonal immunoglobulins may act as a potential trigger in the pathogenesis of TMA. To determine the prevalence of monoclonal gammopathy and clinicopathological features of TMA associated with monoclonal immunoglobulin, we performed a retrospective study in adults (18 and older) with a clinical diagnosis of TMA. Of 146 patients with TMA, we detected monoclonal immunoglobulin in 20 patients (13...
December 17, 2016: Kidney International
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