جستجوی مقالات مرتبط با کلیدواژه « therapeutic plasma exchange » در نشریات گروه « پزشکی »

Therapeutic plasma exchange (TPE) is a plasmapheresis procedure whose Safety data for pediatric neuro-immunological disorders (PNID) is confined. The present research documents TPE’s safety and feasibility data in these conditions.

The current study involved six distinct groups of patients with PNID undergoing TPE: neuromyelitis optic spectrum disorder (NMOSD), autoimmune encephalitis (AIE), acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), Guillain-Barre syndrome (GBS), and optic neuritis (ON). This study documented complications related to each TPE process. In addition, TPE’s efficacy was studied in these patients.

The present study recorded adverse effects in 18 patients with PNID that received 121 TPE cycles: five cycles (4.13%) in MS, three (2.48%) in AIE subgroup, one (0.82%) in ADEM, and two (1.65%) in GBS. No severe complications were observed among the patients.

Patients with PNID tolerated therapeutic plasma exchange, which was a safe process.

Therapeutic plasma exchange (TPE) is a type of treatment, which eliminates harmful antibodies, immune complexes, cytokines, and inflammatory products. Due to the lack of sufficient data on indications, effectiveness, and side effects of TPE in patients with rheumatic disease, we evaluated TPE in our center. All consecutive patients registered in university hospitals with definite rheumatologic indications for TPE during 15 years were evaluated. 680 sessions of TPE were performed on 166 patients, aged between 19 and 83 years. The most common underlying causes were collagen vascular diseases (60%) including systemic lupus erythematosus (SLE) (98%), and antiphospholipid antibody syndrome (APS) (1%); and then, primary small vessel vasculitis (SVV) (39.8%). The main indications for TPE in all patients were rapidly progressive glomerulonephritis (RPGN) (69.8%) and pulmonary hemorrhage (39.1%). During 12 months follow-up, in SLE and SVV patients 17 (17.3%) and 20 (30.3%) entered complete remission; 37 (37.3%) and 12 (18.1%) entered partial remission; 44 (44.8%) and 34 (51.5%) had no recovery; and 37(37%) and 19 (28.7%) died, respectively. A total of 18 (10.8%) patients experienced TPE-related adverse events during TPE [hypotension 15 (9%), allergic reaction 1 (0.6%), fever 1 (0.6%), and hypocalcemia 1 (0.6%)]. The most common indication for TPE is SLE and primary vasculitis. The RPGN and pulmonary hemorrhage were the main indications. Although the rate of response to treatment was acceptable according to the fatal nature of these complications, further case-control studies are suggested to assess the effectiveness of TPE.

Women live longer than men. Cardiovascular disorders, cancers, and serious infectious conditions are less common among women than men. Recent data also indicate that women, particularly before menopause, are less susceptible to severe COVID-19, a viral infection hitting less-healthy individuals. The superiority of women regarding health has not been completely understood and partly been explained by estradiol beneficial effects on the microenvironment of the body, notably cytokine network. Estradiol cycles are aligned with menstruation cycles, a challenge for distinguishing their individual effects on human health. Large-scale, long-term studies indicate that hysterectomy, particularly at younger ages, is associated with an increased risk of mortality, cancer, or heart disorders. The underlying mechanisms for the increased risk in hysterectomized women are hard to be investigated in animal models since only a few primates menstruate. However, blood exchange models could resemble menstruation and provide some insight into possible beneficial effects of menstruation. Sera from animal models (neutral blood exchange) and also humans that have undergone therapeutic plasma exchange enhance the proliferation of progenitor cells in the culture and contain lower levels of proinflammatory factors. If menstruation resembles a blood exchange model, it can contribute to a healthier cytokine network in women. Consequently, menstruation, independently from estradiol health beneficial effects, can contribute to greater longevity and protection against certain disorders, e.g., COVID-19, in women. Investigation of COVID-19 rate/severity in hysterectomized women will provide insight into the possible beneficial effects of menstruation in COVID-19.

COVID-19 pandemic is a global concern. In this study we suggest using a novel three-dimensional treatment mainly based upon immune system modulation to revolve the virus chaos, regarding to the cytokine storm introduced as the main character of COVID-19 infection scenario.

A young man infected by 2019-nCoVwho suffered from respiratory arrest and loss of consciousness(On March 27,2020), undergoes cardiopulmonary resuscitation and then Endotracheal  intubation and upon ICU administration and confirmed diagnosis of COVID-19, Considering critical condition of the young patient, plasmapheresis was performed once on a daily basis, three doses of interferonbeta(IFN-β-1b) was injected subcutaneously every other day and dexamethasone was given at a dose of 4 mg every 8 hours (TID).After 2 days, the patient was extubated and transferred from the ICU to the ward (March 31,2020) where plasmapheresis was performed 4 times daily for 4 days.Finally ,after 7 days of hospitalization, the patient was discharged with a good general condition.

we modulated immune system through plasmapheresis to sweep out the released cytokines and corticosteroid along with interferon andcommon antiviral treatments. Our data suggest this combined method to be effective for critically ill COVID-19 patients.