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Clinical Efficacy of Plasmapheresis for Patients with Acute Severe

Attack CNS Inflammatory Disease in Prasart Neurological Institute

Saharat Aungsumart MD., Metha Apiwattanakul MD.

Prasat Neurological Institute, Department of Medical Service,

Ministry of public health, Bangkok, Thailand

Objectives: To evaluate clinical efficacy of plasmapheresis in severe attack

CNS inflammatory demyelinating disease in Prasart Neurological Institute

Methods: Seventeen patients are diagnosed of CNS inflammatory

demyelinating disease (mainly Neuromyelitis optica spectrum disorder 15

patients, idiopathic transverse myelitis one patient and bilateral simultaneous

optic neuritis in one patient), with had severe acute attack and received

plasmapheresis due to poor respond to high-dose intravenous

methylprednisolone (IVMP) therapy were include in this retrospective study.

The outcomes of this study were functional outcome improvements at 6

months after plasmapheresis.

Results: Immediate effect of plasmapheresis following IVMP therapy led to

significant improvement in 35% (6 patients) of 17 patients and increased to

59% (10 patients) after 6 months follow up. Plasmapheresis was generally well

tolerated in all patients. However serious side effect can be occur due to

insertion of central venous catheter. Younger patient or lower gait score before

attack were associated with significant improvement after 6 month completion

of plasmapheresis (p=0.035 and p= 0.007 respectively). Lower baseline

th
19 Annual Academic Meeting of Prasat Neurological Institute, 2015