Plasma exchange in pediatric patients: analysis of 93 cases

Abstract

Objective To assess the indications, effect and complications of plasma exchange(PE)application in children. Methods A total of 93 patients treated with PE were enrolled, and the clinical manifestations before and after treatment were analyzed retrospectively. Results Ninety-three cases of children received PE treatment 2 to 11 times, an average of 5.5 times, 53 cases with combination blood purification treatment.In 93 patients, there were 36 cases with hemolytic uremic syndrome, among them, 22 cases(61.1%)were healed, 14 cases(38.9%)remained hematuria, and proteinuria and 5 of them(13.9%)with injured renal function.There were 9 cases with Guillain-Barre' syndrome and 8 of them got improved.Six in 8 cases with anti-N-methyl-D-aspartate receptorencephalitis got better after treatment.All of the 3 cases with myasthenia gravis got recovery.There were 4 cases with acute disseminated encephalomyelitis and 4 cases with chronic inflammatory demyelinating polyneuropathy respectively.The treatment effect rate was all 3/4.Four in 9 patients with poisonous mushroom poisoning also got improved.The adverse reactions were observed in 12 cases(12.9%), including allergic in 9 cases and hypotension in 3 patients.No serious adverse reactions were found during treatment. Conclusion PE is an safe and effective blood purification method, with less adverse reaction, for treatment of the atypical hemolytic uremic syndrome and some serious nervous system diseases, such as myasthenia gravis, Guillain-Barre syndrome, etc. Key words: Plasma exchange; Hemolytic uremic syndrome; Nervous system disease; Children