Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2026
Centrifugal Versus Membrane-Based Therapeutic Plasma Exchange in Pediatric Seronegative Neuroimmune Disorders: Neurologic Outcome and Age Specific Safety Profile.
СтатьяНаблюдательное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Ongun Ebru Atike, Aydın Sultan, Kıhtır Hasan Serdar, Çebişli Erdem, Kutluk Muhammed Gultekin, Özcanyüz Duygu Güner, Oz Ayse, Karakuş Volkan
Аннотация
BACKGROUND: This study evaluated the effectiveness of therapeutic plasma exchange (TPE) modalities in seronegative pediatric neuroimmune disorders, focusing on acute therapy response, 6-month neurological outcomes, and age-stratified adverse events.
METHODS: Retrospective observational cohort between 2018 and 2024. Neurological outcomes were assessed at five predetermined set points during 6 months.
RESULTS: Forty-six children underwent 304 TPE procedures in 49 sessions. Early favorable recovery were 84% for autoimmune-encephalitis, 75% for CNS-demyelinating-disorders, 83.3% for Guillan-Barre-syndrome, 66.7% of Juvenile-Myasthenia-Gravis cases. Six-months neurological outcome showed similar recovery rates irrespective-of-TPE-modality used (F[4169] = 0.53, p = 0.711; F[4470] = 0.69, p = 0.602 for CNS and PNS disorders). Adverse events occurred in 20.1% of TPE sessions, were largely age-dependent rather than disease-category or modality-driven, with a 0.891-fold reduction in the likelihood of AE occurrence for each-year increment (OR = 0.891, 95% CI: 0.825-0.962, p = 0.003).
CONCLUSION: Centrifugal and membrane-based TPE are associated with good neurological recovery in seronegative pediatric neuroimmune disorders. Patient age, rather than apheresis modality or disease subtype, has emerged as the primary determinant of the adverse event profile.
METHODS: Retrospective observational cohort between 2018 and 2024. Neurological outcomes were assessed at five predetermined set points during 6 months.
RESULTS: Forty-six children underwent 304 TPE procedures in 49 sessions. Early favorable recovery were 84% for autoimmune-encephalitis, 75% for CNS-demyelinating-disorders, 83.3% for Guillan-Barre-syndrome, 66.7% of Juvenile-Myasthenia-Gravis cases. Six-months neurological outcome showed similar recovery rates irrespective-of-TPE-modality used (F[4169] = 0.53, p = 0.711; F[4470] = 0.69, p = 0.602 for CNS and PNS disorders). Adverse events occurred in 20.1% of TPE sessions, were largely age-dependent rather than disease-category or modality-driven, with a 0.891-fold reduction in the likelihood of AE occurrence for each-year increment (OR = 0.891, 95% CI: 0.825-0.962, p = 0.003).
CONCLUSION: Centrifugal and membrane-based TPE are associated with good neurological recovery in seronegative pediatric neuroimmune disorders. Patient age, rather than apheresis modality or disease subtype, has emerged as the primary determinant of the adverse event profile.