Plasmapheresis in neurological diseases. Experience in 140 procedures in 47 patients

Plasmapheresis can be useful in myasthenia gravis, Guillain Barré syndrome and chronic demyelinating inflammatory polyradiculoneuritis. To report our experience with plasmapheresis in patients with neurological diseases. Retrospective review of plasmapheresis procedures done between 1995 and 2001, in a public hospital. Indications criteria, clinical results and technical yield were analyzed. One hundred fifty nine procedures were reviewed. One hundred forty (88%) were indicated for neurological diseases (44% for Guillain Barré syndrome and 29% for myasthenia gravis). Clinical improvement or eventual complications were avoided in 70% of patients with Guillain Barré syndrome and 100% of patients with myasthenia gravis. Hypotension in 10% and paresthesias in 7% were observed. All complications were successfully controlled with crystalloid or fresh plasma infusions or citrate management. In 11 cases, the procedure was interrupted due to obstruction of the venous access, that was peripheral in eight of these. The most common difficulties of the procedure were delay in performing it in 50% of patients and insufficient exchange volumes in 30%. Plasmapheresis was safe and useful in patients with myasthenia gravis and Guillain Barré syndrome. The drawbacks of the procedure are its costs and requirement of special equipment.