Complications of Therapeutic Plasma Exchange in Patient with Neurological Disorders

Authors

  • Ferdous Ara Associate Professor and Head, Department of Transfusion Medicine, National Institute of Neurosciences and Hospital, Dhaka
  • Mohammad Sayeed Hassan Assistant Professor, Neurology Department, National Institute of Neurosciences and Hospital, Dhaka
  • Md Abdullah Yusuf Assistant Professor, Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka
  • Zubaida Nasreen Medical Officer, Department of Transfusion Medicine, National Institute of Neurosciences and Hospital, Dhaka
  • Aminul Islam Assistant Registrar, Department of Transfusion Medicine, National Institute of Neurosciences and Hospital, Dhaka
  • Md Badrul Alam Professor and Joint Director, National Institute of Neurosciences and Hospital, Dhaka
  • Quazi Deen Mohammad Professor and Director, National Institute of Neurosciences and Hospital, Dhaka

DOI:

https://doi.org/10.3329/jninb.v3i2.36766

Keywords:

Therapeutic plasma exchange, Complication, Neurological disorder

Abstract

Background: Therapeutic plasma exchange (TPE) is a procedure used in neurological disorders where autoimmunity plays a major role. Though it is a relatively safe procedure, severe complications may occur.

Objective: The aim of the present study was to analyze the incidence of TPE related complications in patients with different neurological disorders.

Methodology: This prospective study was conducted in 91 patients, in department of Transfusion Medicine at National Institute of Neurosciences and Hospital (NINS) from February 2014 to January 2017 for a period of three (03) years. All admitted patients with neurological disorders advised for TPE were included in this study.

Results: Age range was from 13 to 70 years with a mean age of 37.14±13.79 years. 67(74%) were men and 24(26.0%) were women. The most common diagnosis was Guillain-Barré Syndrome (GBS) in 79.1 % (n=72) cases followed by myasthenia gravis (MG) in 13.2% (n=12), chronic inflammatory demyelinating polyneuropathy (CIDP) in 6.6 % (n= 6), multifocal motor neuropathy (MMN) in 1.1% (n=1) cases. Total number of 332 TPE sessions was performed with the median of 4 sessions per patient (range 1 to 9). Total 99 (29.8%) adverse reactions occurred in 332 TPE sessions. The most common adverse effect was hypotension (n=35, 10.54 %) followed by allergic reactions (n=29, 8.73 %), access problem (n= 12, 3.61 %) and vomiting (n=8, 2.41 %). Most of the adverse reactions were mild and improved spontaneously or by using simple medications. Out of 332 TPE sessions, 330(99.4%) procedures were completed successfully after managing the adverse reactions. TPE were discontinued in 2 occasions (0.6% of procedures) due to inadequate venous access. There was no mortality related to TPE procedure.

Conclusion: In spite of few complications, TPE can be considered as a safe method of treatment in neurologic disorders when carried out with all necessary precautions.

Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 69-74

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Author Biography

Ferdous Ara, Associate Professor and Head, Department of Transfusion Medicine, National Institute of Neurosciences and Hospital, Dhaka



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Published

2018-05-26

How to Cite

Ara, F., Hassan, M. S., Yusuf, M. A., Nasreen, Z., Islam, A., Alam, M. B., & Mohammad, Q. D. (2018). Complications of Therapeutic Plasma Exchange in Patient with Neurological Disorders. Journal of National Institute of Neurosciences Bangladesh, 3(2), 69–74. https://doi.org/10.3329/jninb.v3i2.36766

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Section

Original Research Articles