Neurology

“Rapid removal of antibodies is important in patients at high risk of neurological dysfunction caused by immunological disorders”.

Neurology

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Acute (AIDP)

Chronic and Acute Inflammatory Demyelinating Polyneuropathy is a rare condition of idiopathic etiology, classified among immune-mediated polyneuropathies, as an autoimmune cause is suspected. The disease affects myelin, which facilitates nerve impulse transmission and protects nerves from external stimuli. When damage extends to the axon, lesions often become irreversible. Approximately 10% of patients present with an acute onset, but subsequent relapses indicate a chronic form with progressive worsening. Main symptoms include peripheral muscle weakness, sensory disturbances, tingling, numbness, lack of balance, and tremor. Treatment includes corticosteroids, immunoglobulins, and plasma exchange, aiming to remove involved antibodies from circulation.

Molecules to remove: Antibodies, Plasmaglobulins, IgG, IgA, IgM; cytokines; inflammation mediators
Recommended Therapies: Plasma Exchange (PEX), Double filtration plasmapheresis (DFPP), Cascade Filtration (CF)

Multiple sclerosis is characterized by widespread areas of demyelination in the brain and spinal cord. Common symptoms include visual and oculomotor abnormalities, paresthesias, weakness, spasticity, urinary disturbances, and mild cognitive symptoms. The pathogenesis of multiple sclerosis is believed to involve an immunological mechanism. A proposed cause is infection triggered by a latent virus (potentially a human herpesvirus such as Epstein-Barr virus), which, once activated, induces a secondary autoimmune response.

Treatment involves corticosteroids for relapses, immunomodulatory drugs for prevention, and plasma exchange to remove circulating antibodies involved.

Molecules to remove: Immunoglobulins (IgA, IgG, IgM), Immune complexes, Cytokines
Recommended Therapies: Plasma Exchange (PEX), Double filtration plasmapheresis (DFPP), Cascade Filtration (CF)

Guillain-Barré syndrome is an acute inflammatory polyneuropathy characterized by muscle weakness and mild distal sensory loss. It is the most common form of acquired inflammatory neuropathy. Although the exact cause is not fully understood, it is believed to be autoimmune in nature. Some variants predominantly involve demyelination, while others affect the axon. Treatment includes immunoglobulins, plasma exchange, and, for severe cases, assisted ventilation.

Molecules to remove: Immunoglobulins (IgA, IgG, IgM); Cytokines
Recommended Therapies: Plasma Exchange (PEX), Double filtration plasmapheresis (DFPP), Cascade Filtration (CF)

Myasthenia gravis is an autoimmune disorder characterized by improper neuromuscular signal transmission due to circulating antibodies against the muscle nicotinic acetylcholine receptor (AchR). Standard treatment involves immunosuppressive drugs and surgical removal of the thymus (the primary lymphoid organ involved in T lymphocyte development). In patients who do not respond to immunosuppressive therapy and require mechanical ventilation, plasma exchange may be applied. The goal is to selectively remove immunoglobulins containing AchR antibodies from the plasma to improve muscle tone and patient symptoms.

Molecules to remove: Immunoglobulins (IgA, IgG, IgM); Cytokines
Recommended Therapies: Plasma Exchange (PEX), Double filtration plasmapheresis (DFPP), Cascade Filtration (CF)

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