Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India

INTRODUCTION: Neuromyelitis optica (NMO) is an idiopathic demyelinating disorder characterized mainly by optic neuritis and myelitis, causing gradual loss of vision and deterioration of neurological function. The underlying pathogenesis mainly involves antibodies against aquaporin 4. The effectivene...

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Main Authors: Dibyajyoti Sahoo, Pragya Silwal, Abhishekh Basavarajegowda
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Asian Journal of Transfusion Science
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Online Access:https://journals.lww.com/10.4103/ajts.ajts_18_22
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author Dibyajyoti Sahoo
Pragya Silwal
Abhishekh Basavarajegowda
author_facet Dibyajyoti Sahoo
Pragya Silwal
Abhishekh Basavarajegowda
author_sort Dibyajyoti Sahoo
collection DOAJ
description INTRODUCTION: Neuromyelitis optica (NMO) is an idiopathic demyelinating disorder characterized mainly by optic neuritis and myelitis, causing gradual loss of vision and deterioration of neurological function. The underlying pathogenesis mainly involves antibodies against aquaporin 4. The effectiveness of therapeutic plasma exchange (TPE) has been shown by many studies across the globe but are only a few from India. We studied ten cases of NMO retrospectively to find out the safety and efficacy of plasma exchange and to know the outcome of those patients who underwent the procedure. MATERIALS AND METHODS: We retrospectively analyzed ten cases of NMO who underwent TPE from January 2017 to July 2021. Out of 153 patients on whom plasma exchange procedures were done during this period, ten cases of NMO were diagnosed and managed with TPE. RESULTS: In our study, we found that 6 of our patients (60%) had a marked improvement noticed clinically with an increase in baseline power of limbs from 0–2/5 to 3–5/5. However, two patients expired after despite TPE. The other two did not show any improvement. Four of our patients started showing clinical improvement after the 2nd–3rd cycles of treatment. TPE was initiated early (within 5 days). There were no notable events in most of the procedures except in one procedure where the patient developed hypotension, her saturation started to drop, and the procedure had to be aborted. CONCLUSION: Our study supports the effectiveness of timely initiation of plasma exchange to improve the overall mortality rate of the patients.
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1998-3565
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spelling doaj-art-5864e961219945f2b3035dd5cf54c2632025-01-08T09:08:22ZengWolters Kluwer Medknow PublicationsAsian Journal of Transfusion Science0973-62471998-35652024-12-0118224825110.4103/ajts.ajts_18_22Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South IndiaDibyajyoti SahooPragya SilwalAbhishekh BasavarajegowdaINTRODUCTION: Neuromyelitis optica (NMO) is an idiopathic demyelinating disorder characterized mainly by optic neuritis and myelitis, causing gradual loss of vision and deterioration of neurological function. The underlying pathogenesis mainly involves antibodies against aquaporin 4. The effectiveness of therapeutic plasma exchange (TPE) has been shown by many studies across the globe but are only a few from India. We studied ten cases of NMO retrospectively to find out the safety and efficacy of plasma exchange and to know the outcome of those patients who underwent the procedure. MATERIALS AND METHODS: We retrospectively analyzed ten cases of NMO who underwent TPE from January 2017 to July 2021. Out of 153 patients on whom plasma exchange procedures were done during this period, ten cases of NMO were diagnosed and managed with TPE. RESULTS: In our study, we found that 6 of our patients (60%) had a marked improvement noticed clinically with an increase in baseline power of limbs from 0–2/5 to 3–5/5. However, two patients expired after despite TPE. The other two did not show any improvement. Four of our patients started showing clinical improvement after the 2nd–3rd cycles of treatment. TPE was initiated early (within 5 days). There were no notable events in most of the procedures except in one procedure where the patient developed hypotension, her saturation started to drop, and the procedure had to be aborted. CONCLUSION: Our study supports the effectiveness of timely initiation of plasma exchange to improve the overall mortality rate of the patients.https://journals.lww.com/10.4103/ajts.ajts_18_22neuromyelitis optica spectrum disordersoptic neuritisplasmapheresisplasma exchangetpe
spellingShingle Dibyajyoti Sahoo
Pragya Silwal
Abhishekh Basavarajegowda
Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
Asian Journal of Transfusion Science
neuromyelitis optica spectrum disorders
optic neuritis
plasmapheresis
plasma exchange
tpe
title Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
title_full Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
title_fullStr Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
title_full_unstemmed Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
title_short Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
title_sort safety and efficacy of therapeutic plasma exchange in neuromyelitis optica a retrospective study from south india
topic neuromyelitis optica spectrum disorders
optic neuritis
plasmapheresis
plasma exchange
tpe
url https://journals.lww.com/10.4103/ajts.ajts_18_22
work_keys_str_mv AT dibyajyotisahoo safetyandefficacyoftherapeuticplasmaexchangeinneuromyelitisopticaaretrospectivestudyfromsouthindia
AT pragyasilwal safetyandefficacyoftherapeuticplasmaexchangeinneuromyelitisopticaaretrospectivestudyfromsouthindia
AT abhishekhbasavarajegowda safetyandefficacyoftherapeuticplasmaexchangeinneuromyelitisopticaaretrospectivestudyfromsouthindia