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Plasma exchange (PE) is a non-selective apheresis technique that can be performed by filtration or centrifugation, allowing rapid purification of high molecular weight pathogenic substances. In nephrology, this technique is widely prescribed as a treatment. We report our experience
This is a retrospective descriptive study over an 8-year period from 2015 to 2022; including all patients who benefited from PE.
We performed 1051 PE sessions on 137 patients. The mean age of the patients was 39, with extremes ranging from 04 to 77 years, and the sex ratio was 0.5. Sixty-two patients were from the nephrology department, 59 from neurology, 2 from paediatrics and 1 from the emergency department. 09 cases of ANCA vasculitis, 3 of Goodpasture's disease, 8 of thrombotic microangiopathy and 4 of cryoglobulinaemia were indicated for PE. Fourteen cases were humoral rejection following renal transplantation and 2 cases of recurrence of segmental and focal hyalinosis. In neurology, the indications for EP were myasthenia in 17 cases, divic optic neuromyelitis in 16 cases, multiple sclerosis in 14 cases, and acute central demyelinating neurological diseases presumed to be autoimmune, neurolupus (certain forms of chronic polyradiculoneuritis in 2 cases, and Guillain-Barré syndrome in 4 cases, including those associated with acute disseminated encephalomyelitis), retrobulbar optic neuritis in 3 cases, amyotrophic lateral sclerosis and a case of Stiff person syndrome. In paediatrics, there was 1 case of Guillain-Barré syndrome, and one patient was referred from the emergency department for severe thrombocytopenia. Complications included allergic reactions, tingling, hypovolaemic shock, seizures and hypocalcaemia. The outcome was favourable in 81% of cases, partial in 6%, unfavourable in 9% and 2% of cases of hypocalcaemia. Progression was favourable in 81% of cases, partial in 6%, unfavourable in 9%, and death occurred in 2%.
Plasmapheresis has been used for several decades, with a wide range of indications: haematological, nephrological, neurological and organ transplantation.