Abstract
<h3>To the Editor.—</h3> We read with great interest the report of the American Medical Association Panel on Therapeutic Plasmapheresis<sup>1</sup>and were surprised that loiasis with hypermicrofilaremia and overwhelming<i>Plasmodium falciparum</i>malaria were not included in the list of indications for apheresis. At least two reports<sup>2,3</sup>give strong evidence for the efficiency of apheresis in the removal of<i>Loa loa</i>microfilaria. This well-tolerated procedure is particularly useful in avoiding severe toxic reactions—in some cases fatal—occurring in patients with a high microfilarial load being treated with diethylcarbamazine. Similarly, automated erythrocyte exchange transfusion has proved effective in rapidly reducing high<i>P falciparum</i>blood load. Erythrocytapheresis combined with transfusion of packed red blood cells using a flow cell separator and specific chemotherapy should be strongly advocated in cases of malaria with either cerebral, renal, pulmonary, or hemostatic complications and parasitemia in excess of 10%.<sup>4-9</sup> Because apheresis may have a useful, and
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