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Intensive plasma exchange for severe autoimmune hemolytic anemia in a four‐month‐old infant
Author(s) -
McCarthy Leo J.,
Danielson Constance F.M.,
Fernandez Christine,
Skipworth Elaine,
Limiac C. Alvin,
Prahlow Timothy,
Goldman Jeffrey
Publication year - 1999
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/(sici)1098-1101(1999)14:4<190::aid-jca8>3.0.co;2-s
Subject(s) - medicine , autoimmune hemolytic anemia , hemolytic anemia , therapeutic plasma exchange , anemia , pediatrics , immunology
We report the smallest infant (7.5 kg) to receive intensive plasma exchange (52 PEs) therapy as treatment of autoimmune hemolytic anemia (AIHA). PE temporarily reduces circulating autoantibody levels and can be an effective adjunctive therapy with corticosteroids and cytotoxic drugs or other immuno‐suppressants. Although his clinical course was prolonged and complicated by cytomegalovirus infection with spontaneous perforation of his colon, his recovery was complete. He has remained healthy for more than 2 years. Because of his small size, calcium gluconate was added to replacement fluids and calcium levels closely monitored. The apheresis machine and tubing were routinely primed with red blood cells and FFP substituted for 5% human albumin during the second half of all procedures to maintain adequate levels of procoagulant. Our experience suggests that intensive PE is helpful in controlling severe AIHA and should be considered even for very small patients. J. Clin. Apheresis 14:190–192, 1999. © 1999 Wiley‐Liss, Inc.