2017 Volume 8 Issue 1 Pages 15-20
Therapeutic apheresis may be applied as treatment for various diseases, in which evidence of its efficacy has been established by randomized controlled trials, or apheresis can remove the pathogenic substance. Among neuroimmunological diseases, myasthenia gravis, Guillain-Barré syndrome, chronic inflammatory demyelinating neuropathy, and multiple sclerosis are accepted as covered under insurance and are applicable diseases that can be treated with apheresis in Japan. Apheresis can be also performed for neuromyelitis optica and autoimmune encephalitis. The modalities of the apheresis used in treatment of neuroimmunological disease are plasma exchange, double filtration plasmapheresis and immnoadsorption plasmapheresis. These seem to be equally effective in each disease mentioned above, but there is as yet no clinical trial evidence about which modality is most suitable for each disease. The condition of a patient needing apheresis therapy in neuroimmunological diseases is often severe and serious, and if the opportunity is not availed, recovery often becomes difficult. Thus it is important to enforce apheresis therapy immediately when necessary, while performing an appropriate differential diagnosis.
