AbstractBackground: Plasmapheresis is the treatment of choice in several immune mediated neurological disorders such as Guillain-Barré syndrome and myasthenia gravis. There are only a few studies from India that have looked in to the outcomes and complications related to therapeutic plasmapheresis in neurological disorders. This study was done to examine the indications, complications and outcomes of plasmapheresis in neurological disorders.
Materials & Methods: A retrospective study of patients who underwent plasmapheresis for neurological disorders during last five years was done. Demographic, clinical data, indications, complications related to the procedure, clinical outcome and long term follow up data were collected and analyzed.
Results: Data of sixty patients, who underwent a total of 276 sessions of plasmapheresis were analyzed. Fifty two percent were males and mean age was 45 years. Twenty nine patients (49%) had Acute Inflammatory Demyelinating Polyradiculoneuropathy, 14 (23%) had Myasthenia Gravis and four patients had Acute Disseminated Encephalomyelitis (7%). Other indications were Chronic Inflammatory Demyelinating Polyradiculoneuropathy, transverse myelitis, polymyositis, autoimmune encephalitis, muscular dystrophy, neuromyeltis optica and Febrile infection related epilepsy syndrome. In patients with AIDP, 26 patients (89%) improved. In patients with MG 11 patients (78%) improved. All patients with Autoimmune encephalitis, Polymyositis, Transverse myelitis and Neuromyelitisoptica showed improvement. There was no improvement in patients with Muscular dystrophy and FIRES. Allergic reactions to plasma, intravascular hemolysis and hypotension were the side effects noted which were managed efficiently during procedure. Mild coagulopathy was observed in three patients, but there were no bleeding complications. There were no other significant complications related to procedure. After a mean follow up period of 3 years, 35 patients had complete remission, 10 patients had relapse, 2 patients died whereas 13 patients lost to follow up.
Conclusion: Plasmapheresis is an effective and safe treatment modality in various immune mediated neurological disorders.
Keywords: Plasmapheresis; AIDP; Myasthenia Gravis.