THERAPEUTIC PLASMA EXCHANGE IN PATIENTS WITH NEUROLOGICAL DISEASES: A 9-YEAR, SINGLE-CENTER EXPERIENCE

Abstract

Objective: Therapeutic plasma exchange (TPE), is based on the removal of pathogenic substrates from plasma with replacement fluid. TPE is being used in the treatment of many neurological diseases, especially Myasthenia Gravis (MG) and Guillain Barre Syndrome (GBS). The aim of this study is to analyse the efficay and safety of TPE experience in neurological disorders. Methodology: We reviewed the medical records of all 59 patients who received a total of 267 therapeutic cycles between 2012 and 2021 in our tertiary care university hospital. Respond assesment was evaluated with Medical Research Council (MRC) scoring system. Neutrophil count, lymphocyte count and neutrophil/lymphocyte ratio was recorded before any treatment and 7 days after the last plasmapheresis cycle. Results: Of the 59 patients, 30 (50.8%) were male and 29 (49.2%) were female. Of these patients 44.1% were diagnosed with MG, 27.3% with GBS, %8.5 with Multiple Sclerosis (MS). The median number of TPE sessions per patient was 5 [1-7]. 33.9 % of patients had at least one complication that hypotension was the most seen (%22). Overall response rate was %76.3. MRC score was significantly higher in the group with response than the group without symptom regression (p <0.05). Conclusion: TPE is a safe and an effective treatment option in neurological diseases. TPE related side effects/complications were generally mild to moderate and manageable. Performing the TPE response evaluation with the MRC scoring system was beneficial for the reliability of the efficacy as a concrete finding.