Complications of Therapeutic Plasma Exchange in Patient with Neurological Disorders
Keywords:Therapeutic plasma exchange, Complication, Neurological disorder
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
How to Cite
Copyright on any research article in the Journal of National Institute of Neurosciences Bangladesh is retained by the author(s).
The authors grant the National Institute of Neurosciences Bangladesh a license to publish the article and identify itself as the original publisher.
Articles in the Journal of National Institute of Neurosciences Bangladesh are Open Access articles published under the Creative Commons CC BY-NC License (https://creativecommons.org/licenses/by-nc/4.0/)
This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.