Abstract
Eight patients with hyperviscosity syndrome and two patients with autoimmune diseaes underwent a course of therapeutic pheresis on an intermittent flow cell separator.
A patient with dermatomyositis had not responded to prednisolone, and spontaneous pneumothorax had developed following massive cough caused by interstitial pneumonitis.
Three plasma exchanges combined with azathioprine therapy produced reduction of circulating immune complex and clinical improvement.
A patient with myasthenia gravis whose symptoms were not controlled with anticholinesterases had suffered from respiratory failure before thymectomy. Plasma exchange was performed five times over fourteen days period, with removal of total of 9,700ml of plasma.
The levels of C3c and C4 in patient's serum and have subsequently been normal, and a dramatic improvement in all affected muscle groups was observed.
The vital capacity rose from 1,940ml to 2,940ml, therefore thymectomy was performed without a difficulty of anesthetic management. Thereafter, she has been maintained on anticholinesterases alone.
In two patients with hyperviscosity syndrome who were treated with plasma exchange for one case and cytapheresis for the other, an improvement in the value of A-aDO2 was observed following the procedure.
It is cocluded that therapeutic pheresis using a cell separator may be valuable as an adjuvant to the treatment of hematologic and autoimmune diseases and it is safe for the patient.
