PMID- 22456283
OWN - NLM
STAT- MEDLINE
DCOM- 20120726
LR  - 20120329
IS  - 1531-6963 (Electronic)
IS  - 1040-8711 (Linking)
VI  - 24
IP  - 3
DP  - 2012 May
TI  - Therapeutic plasma exchange in systemic vasculitis: an update on indications and 
      results.
PG  - 261-6
LID - 10.1097/BOR.0b013e3283526509 [doi]
AB  - PURPOSE OF REVIEW: Therapeutic plasma exchange has been long proposed as a 
      potentially useful modality to treat several systemic vasculitis conditions. This 
      review summarizes the available evidence for the effectiveness of plasma exchange 
      in systemic vasculitis. RECENT FINDINGS: Therapy with plasma exchange, most often 
      combined with immunosuppressive agents, has been found effective for 
      antiglomerular basement membrane disease, antineutrophil cytoplasmic 
      antibody-associated vasculitis (AAV), Henoch-Schonlein purpura, cryoglobulinemic 
      vasculitis, hepatitis B virus-associated polyarteritis nodosa and Kawasaki 
      disease. The most common indications are life-threatening or organ 
      function-threatening manifestations, particularly advanced renal dysfunction and 
      disease refractory to traditional therapy. Thus, most of the available evidence 
      favoring plasma exchange in these circumstances is from small observational 
      studies or expert consensus. Recent advances in findings include results 
      strengthening the notion of a small beneficial effect on preserving renal 
      function with adjunct plasma exchange therapy in AAV with renal failure and 
      observational data suggesting plasma exchange as a promising effective salvage 
      option for children with Kawasaki disease not responding to standard therapy with 
      intravenous immunoglobulins. SUMMARY: Evidence from case reports and case series 
      and a few randomized controlled trials continues to support plasma exchange as a 
      major rescue-treatment modality for several systemic vasculitis diseases. These 
      studies offer some guidance for use of plasma exchange in systemic vasculitis, 
      but additional data from controlled trials are needed for more accurate 
      assessment of the indications, practical modalities, benefits and shortcomings of 
      this treatment approach.
FAU - Mahr, Alfred
AU  - Mahr A
AD  - Department of Internal Medicine, Hospital Saint-Louis, University Paris, Paris, 
      France. alfred.mahr@sls.aphp.fr
FAU - Chaigne-Delalande, Severin
AU  - Chaigne-Delalande S
FAU - De Menthon, Mathilde
AU  - De Menthon M
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Rheumatol
JT  - Current opinion in rheumatology
JID - 9000851
SB  - IM
MH  - Autoimmune Diseases/therapy
MH  - Humans
MH  - Immune Complex Diseases/therapy
MH  - Mucocutaneous Lymph Node Syndrome/therapy
MH  - Plasma Exchange/*methods
MH  - Systemic Vasculitis/*therapy
MH  - Treatment Outcome
EDAT- 2012/03/30 06:00
MHDA- 2012/07/27 06:00
CRDT- 2012/03/30 06:00
PHST- 2012/03/30 06:00 [entrez]
PHST- 2012/03/30 06:00 [pubmed]
PHST- 2012/07/27 06:00 [medline]
AID - 00002281-201205000-00004 [pii]
AID - 10.1097/BOR.0b013e3283526509 [doi]
PST - ppublish
SO  - Curr Opin Rheumatol. 2012 May;24(3):261-6. doi: 10.1097/BOR.0b013e3283526509.