こう原病患者に対する血しょう交換療法

Abstract

Plasma exchange was performed in a total 18 patients of 11 rheumatoid arthritis (RA), 3 progressive systemic sclerosis (PSS), 1 polymyositis (PM), 1 dermatomyositis (DM) and 2 mixed connective tissue disease (MCTD) . Serum levels of immunoglobulins and complement and also numbers of lymphocyte subsets and its function were measure before and after treatment. Plasma separator AP-05-H (ASAHI Medical Co.) with menbrane filters was used as substitute for the exchanged plasma of 2, 000 to 3, 000ml in each trial.The treatment seemed to be effective in 9 of 11 RA patients and two of which showed a disappearance of their subcutaneous nodules. The Skin ulcers in the legs found in 2 PSS patients decreased in their size and sclerosis of the skin found in one PSS patient relieved. Respiratory disorder found in one PM patient improved. Muscle weakness and histologic finding of myositis found in one DM patient improved. Severe myalgia and muscle weakness in one MCTD patient improved.In laboratory data, serum levels of total protein, γ-globulin, immunoglobulin class of IgG, IgA and IgM, C3 and C4 decreased significantly. Decrease of numbers of OKT-8 positive cells and increase of the ratio of OKT-4/OKT-8 positive cell were significant.