Bacteremia in autoimmune bullous disease patients undergoing double-filtration plasmapheresis.

Background

Plasmapheresis is one of the treatment options for autoimmune bullous disease (AIBD).

Objective

To evaluate the incidence of adverse events occurring during a course of plasmapheresis.

Methods

This study enrolled 42 courses of double-filtration plasmapheresis (DFPP) from 28 patients with AIBD treated in Kurume University Hospital between 2007 and 2016. We examined the frequency of adverse events during the course of DFPP and associated features.

Results

The most frequent adverse event was bacteremia (13 of 42 courses, 31.0%), followed by subcutaneous hemorrhage (1 course, 2.4%), and an abscess at the catheterization sites (1 course, 2.4%). No adverse event-related death was recorded. In the analysis of bacteremia occurrence, the erosion at the catheterization sites, the use of central venous catheter (CVC), and the number of DFPP cycles per course were significantly more or greater in the bacteremia group than in the non-bacteremia group (p = .0474, .0005, and .0035, respectively).

Conclusions

Although DFPP is a good treatment option for AIBD, attention needs to be paid for the development of possible risks during a DFPP course. We believe that our results can be applied to other plasmaphereses in AIBD management.