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Immunoadsorption therapy for neuromyelitis optica spectrum disorders long after the acute phase
Author(s) -
Kobayashi Masatake,
Nanri Kazunori,
Taguchi Takeshi,
Ishiko Tomoko,
Yoshida Masaharu,
Yoshikawa Noriko,
Sugisaki Kentaro,
Tanaka Nobuyuki
Publication year - 2015
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/jca.21324
Subject(s) - medicine , immunoadsorption , neuromyelitis optica , transverse myelitis , optic neuritis , apheresis , myelitis , plasmapheresis , multiple sclerosis , gastroenterology , dermatology , surgery , antibody , immunology , platelet , spinal cord , psychiatry
Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease with exacerbations involving recurrent or bilateral optic neuritis and longitudinally extensive transverse myelitis. Pulse steroid therapy is recommended as the initial, acute‐phase treatment for NMO. If ineffective, treatment with plasma exchange (PE) should commence. However, no evidence exists to support the effectiveness of PE long after the acute phase. Immunoadsorption therapy (IA) eliminates pathogenic antibodies while sparing other plasma proteins. With IA, side effects of PE resulting from protein substitution can be avoided. However, whether IA is effective for NMO remains unclear. We describe a patient with anti‐aquaporin‐4‐positive myelitis who responded to IA using a tryptophan polyvinyl alcohol gel column that was begun 52 days after disease onset following the acute phase. Even long after the acute phase when symptoms appear to be stable, IA may be effective and should not be excluded as a treatment choice. J. Clin. Apheresis 30:43–45, 2015. © 2014 Wiley Periodicals, Inc.