Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder
Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder
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DOI：
10.1177/1352458508100837
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发表时间：
2009-04-01
影响因子：
5.8
通讯作者：
Cabre, P.
中科院分区：
文献类型：
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作者：
Bonnan, M.;Valentino, R.;Cabre, P.
背景血浆置换(PE)越来越多地用于涉及体液因素的疾病，并被证明对急性脱髓鞘疾病是有益的。复发性视神经脊髓炎(NMO)和广泛横贯性脊髓炎(ETM)的脊椎发作通常是毁灭性的。在29次发作中，PE作为一种附加疗法。在发病前、急性期和残留期进行扩展残疾状态评分(EDSS)。我们将Delta EDSS定义为从基础到残余EDSS的上升。结果PE组Delta EDSS较低(1.2+/-1.6 vs 2.6+/-2.3；P<；0.01)。较低的基础损伤与较好的结果相关。在NMO-IgG阴性和阳性NMO攻击中都得到了改善。在7次PE治疗中出现了轻微的不良反应(24%)。结论PE是一种安全的附加治疗方法，可用于严重脊椎发作的NMO谱系障碍的早期治疗，以最大限度地提高改善率。PE效率与NMO-Ig G阳性无关。多发性硬化症2009；15：487-492。Http://msj.sagepub.com
Background Plasma exchange (PE) is increasingly undertaken in diseases involving humoral factors and is proven to be beneficial in acute demyelinating diseases. Spinal attacks in relapsing neuromyelitis optica (NMO) and in extensive transverse myelitis (ETM) - a truncated form of NMO with spinal involvement - are usually devastating.Objective We retrospectively studied the outcome of PE-treated versus steroid-only treated spinal attacks in relapsing NMO and ETM.Methods We included 96 severe spinal attacks in 43 Afro-Caribbean patients. PE was given as an add-on therapy in 29 attacks. Expanded disability status score (EDSS) was obtained before attack, during the acute and residual stage. We defined the Delta EDSS as the rise from basal to residual EDSS.Results The Delta EDSS was found to be lower in the PE-treated group (1.2 +/- 1.6 vs 2.6 +/- 2.3; P < 0.01). A low basal impairment is associated with a better outcome. Improvement was obtained in both NMO-IgG negative and positive NMO attacks. Minor adverse events manifested in seven PE sessions (24%).Conclusion PE appears to be a safe add-on therapy that may be employed early in severe spinal attacks in the NMO spectrum disorders in order to maximize improvement rate. PE efficiency is independent of NMO-IgG positivity. Multiple Sclerosis 2009; 15: 487-492. http://msj.sagepub.com