What Conditions Can Plasmapheresis Treat?

June 17, 2024

Plasmapheresis is a type of treatment process involving the removal of harmful antibodies, cryoglobulin, endotoxin, immune complex, myeloma light chains, cholesterol-containing lipoprotein, or another substance from a patient's blood. While plasmapheresis is similar to dialysis in its mechanism, it specifically filters the problematic substance from the plasma component of the blood. A healthy individual does not have harmful antibodies that can cause damage to other body tissues, but individuals affected by autoimmune diseases and disorders do. Each session can last anywhere from one to three hours depending on what needs to be filtered, and if anything needs to be augmented before the plasma is returned to the patient's body. The frequency of treatment sessions is dependent on the rate of the individual's production of the problem substance. Plasmapheresis can be utilized to help treat the symptoms of numerous disorders, but it does not remove the source of the disorder.

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Multiple Sclerosis

Multiple sclerosis is a disabling disease that causes damage in an affected individual's spinal cord and brain. Patients with multiple sclerosis have an immune system that inappropriately attacks the protective myelin sheath surrounding the nerves. Without the myelin, nerves become damaged and can no longer transmit nerve signals correctly. Multiple sclerosis patients have problems with their vision, muscle control, balance, and other functions. Plasmapheresis is a form of treatment used for multiple sclerosis to mediate sudden attacks or flare-ups. Certain proteins in the affected individual's plasma cause the immune system to attack the myelin sheath that protects the nerve cells in the central nervous system. Plasmapheresis is able to remove these proteins from a patient's plasma and reduce the effects and complications that occur with multiple sclerosis relapses. Plasmapheresis needs to begin within twenty days of when the patient started to experience symptoms of a relapse. Plasmapheresis is a short-term solution for multiple sclerosis management that requires weekly visits to a medical facility to receive the treatment.

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Myasthenia Gravis

Myasthenia gravis is an autoimmune disease that affects the function of an individual's skeletal muscles. These muscles include those that perform vital functions such as the heart and those that move the lungs, as well as muscles responsible for moving the limbs. Commonly affected muscles in patients with myasthenia gravis include those that control facial expression, talking, eye movement, chewing, swallowing, and eyelid movement. In a healthy individual, electrical impulses communicate between nerves and other cells by the release of acetylcholine that binds to its receptors on the receiving nerve or cell. However, the immune system of a myasthenia gravis patient produces antibodies that destroy, alter, or block the acetylcholine receptors where the nerve meets the muscle. This malfunction results in no nerve transmission to the muscle cells to initiate a muscle contraction, causing muscle weakness. Plasmapheresis can be used to remove the harmful antibodies and replace them with donor plasma or a plasma substitute. Plasmapheresis can improve a patient's symptoms and improve muscle function for up to two weeks.

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Guillain-Barre Syndrome

Guillain-Barre syndrome is an uncommon disorder that affects an individual's peripheral nervous system, the network of nerves located outside of the spinal cord and brain. The exact mechanism of what causes Guillain-Barre syndrome is unclear, but it is thought an affected individual's immune system is triggered to fight infection and some substances on the bacteria or virus are similar to those present on some of the healthy nerve cells in the body. The immune system then mistakenly attacks these healthy nerves and damages them, causing the patient to have muscle weakness and changes in sensation. Plasmapheresis can help treat Guillain-Barre syndrome because it is able to separate the plasma from the rest of the blood and then replace it with artificial plasma or donor plasma. This process takes out the immune system antibodies in the blood plasma that are inappropriately attacking the patient's nerve cells. In severe cases, plasmapheresis has proven to shorten the overall duration of the Guillain-Barre syndrome symptoms. Plasmapheresis is typically needed for one to two weeks with a session every other day to improve a patient's muscle weakness and function.

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Chronic Inflammatory Demyelinating Polyneuropathy

Chronic inflammatory demyelinating polyneuropathy is a disorder that affects the nervous system by causing inflammation in the nerves around the body. As a result, the nerves swell, and the protective myelin sheath around the nerve is destroyed. The nerves are then impaired from performing their function of transmitting signals. Common symptoms in individuals affected by chronic inflammatory demyelinating polyneuropathy include symmetric muscle weakness, motor function difficulty, sensation loss, clumsiness, double vision, fatigue, burning, and difficulty with swallowing. While chronic inflammatory demyelinating polyneuropathy is similar to Guillain-Barre syndrome, it lasts for at least eight weeks and does not improve on its own over time without medical intervention. Plasmapheresis for the treatment of an individual affected by chronic inflammatory demyelinating polyneuropathy works similarly to the plasmapheresis process used to treat Guillain-Barre syndrome. However, patients with this disorder have to undergo plasmapheresis for a longer duration and sometimes have to have more than one cycle.

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PANDAS Syndrome

Pediatric autoimmune neuropsychiatric disorders associated with streptococcus or PANDAS syndrome is characterized by acute changes in behavior, personality, and movement around six weeks after being infected by Streptococcus pyogenes. The symptoms of PANDAS syndrome in affected individuals are close to those linked to Tourette syndrome and obsessive-compulsive disorder. These symptoms come on suddenly and become worse within a matter of days. PANDAS syndrome occurs when the patient's immune system produces antibodies to fight off the strep bacteria. The strep bacteria are known to methodically disguise themselves using substances similar to the substances that can be found on healthy cells. This disguise causes the immune system antibodies to attack a part of the brain called the basal ganglia, resulting in the psychiatric and physical symptoms of PANDAS syndrome. Plasmapheresis is a treatment used in individuals affected by cases of PANDAS syndrome that are not responding to other therapies and medications. Plasmapheresis removes the antibodies responsible for attacking the basal ganglia. PANDAS syndrome can become a chronic issue in some patient, but most who are treated for it recover without any long-term adverse effects.

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