Effectiveness and safety of therapeutic plasma exchange in neurological disorders; measuring the response to treatment using Modified Rankin Scale - A single-center study.

INTRODUCTION

Therapeutic plasma exchange (TPE) is commonly used as a treatment modality in varying neurological disorders. Response to TPE in neurological disorders is usually noted in "subjective" terms. We, measured response to treatment, objectively, using Modified Rankin Scale (MRS).

MATERIALS AND

METHODS

This was an observational prospective study in patients diagnosed with autoimmune neurological disorders (AND) who underwent TPE, in addition to intravenous immunoglobulin, and/or prednisolone. This study was carried out at a tertiary care center. Demographic data, procedure details including adverse reactions, and clinical responses were collated. Clinical response was assessed by applying MRS, in different neurological disorders, before (pre-TPE) and after TPE (post-TPE). Pre- and post-TPE clinical conditions were compared using the Wilcoxon matched-pairs signed-ranks test.

RESULTS

Fifty-three patients were included, with 15 females and 38 males, who had a median age of 48 years. Seven different AND were; myasthenia gravis (n = 11), Guillain-Barre syndrome (n = 18), neuromyelitis Optica spectrum disorders (n = 6); chronic inflammatory demyelinating polyneuropathy (n = 5); autoimmune encephalitis (n = 6); transverse myelitis (n = 6); and multiple sclerosis (n = 1). Patients received a median of 5 cycles of TPE and a mean 1.5 plasma volume was exchanged. The improvement in the MRS scale was significant when post-TPE scores were compared with pre-TPE scores. The most common adverse reaction was shivering (n = 5; 1.85%), which was managed conservatively.

CONCLUSION

TPE was shown to be an effective and safe treatment modality in providing relief to patients with neurological disorders.