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WHAT IS THERAPEUTIC PLASMA EXCHANGE?

Plasma exchange is utilised when it becomes necessary to remove disease-causing antibodies, referred to as proteins, from a patient's system. These antibodies, stemming from an irregular immune system, have the potential to attack and damage healthy organs. Often, selectively eliminating the specific disease-causing protein proves to be a challenging task, thus requiring the removal of whole plasma as an effective means to address the illness.

WHAT conditions can therapeutic plasma exchange treat?

The following conditions are considered indications for therapeutic plasma exchange, which is a recommended first-line therapy based on strong research evidence:

Neurology: Acute Guillain-Barré syndrome, Chronic inflammatory demyelinating polyneuropathy, Myasthenia gravis, Polyneuropathy associated with paraproteinemias, and PANDAS.

Haematology: Thrombotic thrombocytopenic purpura, Atypical hemolytic uremic syndrome (autoantibody to factor H), Hyperviscosity syndromes (paraproteinemias), and Severe/symptomatic cryoglobulinemia.

Renal: Goodpasture's syndrome (anti-glomerular basement membrane antibodies), Antineutrophil cytoplasmic antibody (ANCA)-associated rapidly progressive glomerulonephritis, Recurrent focal segmental glomerular sclerosis, and Antibody-mediated renal transplant rejection.

Metabolic: Familial hypercholesterolemia (homozygous) and Fulminant Wilson's disease.

Paediatric: Autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS).

The following conditions are considered indications for therapeutic plasma exchange, which is an established second-line therapy:

Neurology: Lambert-Eaton myasthenic syndrome, Acute exacerbation of multiple sclerosis, Chronic focal encephalitis, and Neuromyelitis optica.

Haematology: ABO-incompatible hematopoietic stem cell transplantation, Pure red cell aplasia, Life-threatening cold agglutinin disease, Atypical hemolytic uremic syndrome (complement factor gene mutations), Myeloma with cast nephropathy, and Red cell alloimmunization in pregnancy.

Immunological: Catastrophic antiphospholipid syndrome and Cerebral systemic lupus erythematosus (SLE).

Metabolic: Refsum's disease.

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