ABSTRACT

The aim of this study was to report our experience with therapeutic plasmapheresis for neurological diseases in regard to the indications, technique and complications in our pediatric intensive care unit. We aimed to emphasize the role of plasmapheresis in treatment resistant and progressive neurological diseases.

We performed retrospective medical record analysis of 41 patients who were treated with plasmapheresis for neurological disorders between July 2005 and April 2015 at Çukurova University Balcalı Hospital Pediatric Intensive Care Unit.

The most common indication for therapeutic plasmapheresis was Guillain Barre Syndrome (46.3% ) followed by autoimmune encephalitis (24.4%), acute disseminated encephalomyelitis (12.2%), myasthenia gravis (9.8%) and refractory status epilepticus (7.3%). For the replacement albumin+fresh frozen plasma mixture (83%), albumin alone (4,6%) and fresh frozen plasma alone(2,4%) were used. During procedures ACD-A was used for anticoagulation, and calcium gluconate was infused routinely. The most frequent complication was hypotension(29.2%).The remainder were allergic reactions like fever andurticaria(9.7%) and hypertension (4.8%). There was no death related to plasmapheresis.

Therapeutic plasmapheresis is the first line treatment for neurological diseases which progress rapidly and are unresponsive to conventional treatments like Guillain Barre Syndrome, acute disseminated encephalomyelitis and myasthenia gravis. There is more to learn about the role of plasmapheresis treatment for autoimmune encephalitis and refractory status epilepticus.

Keywords: Neurological disease, therapeutic plasmapheresis, child