Plasma Exchange in Severe Attacks of Neuromyelitis Optica
Background. Neuromyelitis optica (NMO) attacks are poorly controlled by steroids and evolve in stepwise neurological impairments. Assuming the strong humoral response underlying NMO attacks, plasma exchange (PLEX) is an appropriate technique in severe NMO attacks. Objective. Presenting an up-to-date...
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Hindawi Limited
2012-01-01
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Series: | Multiple Sclerosis International |
Online Access: | http://dx.doi.org/10.1155/2012/787630 |
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doaj-214a886073f7443cad605b301af6c62f2020-11-24T23:58:36ZengHindawi LimitedMultiple Sclerosis International2090-26542090-26622012-01-01201210.1155/2012/787630787630Plasma Exchange in Severe Attacks of Neuromyelitis OpticaMickael Bonnan0Philippe Cabre1Service de Neurologie, Hopital F. Mitterand, 64000 Pau, FranceService de Neurologie, Hôpital Zobda Quitman, 97261 Fort de France, MartiniqueBackground. Neuromyelitis optica (NMO) attacks are poorly controlled by steroids and evolve in stepwise neurological impairments. Assuming the strong humoral response underlying NMO attacks, plasma exchange (PLEX) is an appropriate technique in severe NMO attacks. Objective. Presenting an up-to-date review of the literature of PLEX in NMO. Methods. We summarize the rationale of PLEX in relation with the physiology of NMO, the main technical aspects, and the available studies. Results. PLEX in severe attacks from myelitis or optic neuritis are associated with a better outcome, depending on PLEX delay (“time is cord and eyes”). NMO-IgG status has no influence. Finally, we build up an original concept linking the inner dynamic of the lesion, the timing of PLEX onset and the expected clinical results. Conclusion. PLEX is a safe and efficient add-on therapy in NMO, in synergy with steroids. Large therapeutic trials are required to definitely assess the procedure and define the time opportunity window.http://dx.doi.org/10.1155/2012/787630 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mickael Bonnan Philippe Cabre |
spellingShingle |
Mickael Bonnan Philippe Cabre Plasma Exchange in Severe Attacks of Neuromyelitis Optica Multiple Sclerosis International |
author_facet |
Mickael Bonnan Philippe Cabre |
author_sort |
Mickael Bonnan |
title |
Plasma Exchange in Severe Attacks of Neuromyelitis Optica |
title_short |
Plasma Exchange in Severe Attacks of Neuromyelitis Optica |
title_full |
Plasma Exchange in Severe Attacks of Neuromyelitis Optica |
title_fullStr |
Plasma Exchange in Severe Attacks of Neuromyelitis Optica |
title_full_unstemmed |
Plasma Exchange in Severe Attacks of Neuromyelitis Optica |
title_sort |
plasma exchange in severe attacks of neuromyelitis optica |
publisher |
Hindawi Limited |
series |
Multiple Sclerosis International |
issn |
2090-2654 2090-2662 |
publishDate |
2012-01-01 |
description |
Background. Neuromyelitis optica (NMO) attacks are poorly controlled by steroids and evolve in stepwise neurological impairments. Assuming the strong humoral response underlying NMO attacks, plasma exchange (PLEX) is an appropriate technique in severe NMO attacks. Objective. Presenting an up-to-date review of the literature of PLEX in NMO. Methods. We summarize the rationale of PLEX in relation with the physiology of NMO, the main technical aspects, and the available studies. Results. PLEX in severe attacks from myelitis or optic neuritis are associated with a better outcome, depending on PLEX delay (“time is cord and eyes”). NMO-IgG status has no influence. Finally, we build up an original concept linking the inner dynamic of the lesion, the timing of PLEX onset and the expected clinical results. Conclusion. PLEX is a safe and efficient add-on therapy in NMO, in synergy with steroids. Large therapeutic trials are required to definitely assess the procedure and define the time opportunity window. |
url |
http://dx.doi.org/10.1155/2012/787630 |
work_keys_str_mv |
AT mickaelbonnan plasmaexchangeinsevereattacksofneuromyelitisoptica AT philippecabre plasmaexchangeinsevereattacksofneuromyelitisoptica |
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