Plasma exchange in selected patients with juvenile rheumatoid arthritis
Identifieur interne : 003786 ( Main/Exploration ); précédent : 003785; suivant : 003787Plasma exchange in selected patients with juvenile rheumatoid arthritis
Auteurs : Earl J. Brewer Jr. [États-Unis] ; Robert W. Nickeson Jr. [États-Unis] ; Roger D. Rossen [États-Unis] ; Donald A. Person [États-Unis] ; Edward H. Giannini [États-Unis] ; John D. Milam [États-Unis]Source :
- The Journal of Pediatrics [ 0022-3476 ] ; 1981.
English descriptors
- Teeft :
- Albumin replacement, Albumin solution, Antinuclear antibody, Arthritis, Arthritis rheum, Articular disease, Base line, Binding activity, Clinical improvement, Complement components, Cricoarytenoid arthritis, Erosive arthritis, Exchange therapy, Final plasma exchange, First exchange, Gold salt therapy, Gold salts, Growth pattern, Houghton mifflin company, Immune, Immune complexes, Intensive care, Joint disease, Laryngeal edema, Myasthenia gravis, Partial remission, Partial thromboplastin time, Pediatrics february, Plasma, Plasma exchange, Plasma exchange therapy, Plasma exchanges, Plasmapheresis, Platelet count, Prednisone, Prothrombin time, Remission, Replacement fluid, Research procedure, Rheum, Rheumatoid, Rheumatoid arthritis, Rheumatoid factor, Second patient, Second series, Serum cholesterol concentration, Spiking fever, Splenic function, Steroid, Steroid requirement, Steroid therapy, Systemic disease, Systemic onset, Texas hospital, Thoracic duct drainage, Transient decreases, Unknown nature, Visual acuity.
Abstract
Plasma exchange with either fresh-frozen plasma or 5% albumin solution as replacement fluid was performed in four selected patients with juvenile rheumatoid arthritis unresponsive to standard therapy. One 13-year-old boy with life-threatening systemic disease experienced a partial remission of disease and tolerated a decrease in prednisone dose from 15 to 4 mg daily following 14 exchanges with FFP. A 14-year-old girl, dwarfed by systemic disease and long-term corticosteroid therapy, was able to discontinue prednisone and grew 6.3 cm in 11 months following 18 plasma exchanges with FFP. An 8-year-old girl with pauciarticular disease, antinuclear antibody, and uncontrollable iridocyclitis underwent 16 plasma exchanges with 5% albumin solution as replacement; despite removal of antinuclear antibody, her eye disease and arthritis were not helped. A 16-year-old girl with erosive, polyarticular JRA showed no detectable change in her articular disease following nine exchanges. Transient decreases in hematocrit, complement components, and immunoglobulin concentrations occurred. In three patients Westergren sedimentation rate decreased for up to five months after exchanges. One patient died suddenly during an exchange with FFP; the cause of death appeared related to microemboli of unknown nature found in the lungs at autopsy. Plasma exchange should be done only in an intensive care setting and as a research procedure for children with JRA.
Url:
DOI: 10.1016/S0022-3476(81)80634-8
Affiliations:
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One 13-year-old boy with life-threatening systemic disease experienced a partial remission of disease and tolerated a decrease in prednisone dose from 15 to 4 mg daily following 14 exchanges with FFP. A 14-year-old girl, dwarfed by systemic disease and long-term corticosteroid therapy, was able to discontinue prednisone and grew 6.3 cm in 11 months following 18 plasma exchanges with FFP. An 8-year-old girl with pauciarticular disease, antinuclear antibody, and uncontrollable iridocyclitis underwent 16 plasma exchanges with 5% albumin solution as replacement; despite removal of antinuclear antibody, her eye disease and arthritis were not helped. A 16-year-old girl with erosive, polyarticular JRA showed no detectable change in her articular disease following nine exchanges. Transient decreases in hematocrit, complement components, and immunoglobulin concentrations occurred. In three patients Westergren sedimentation rate decreased for up to five months after exchanges. One patient died suddenly during an exchange with FFP; the cause of death appeared related to microemboli of unknown nature found in the lungs at autopsy. Plasma exchange should be done only in an intensive care setting and as a research procedure for children with JRA.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Brewer Jr, Earl J" sort="Brewer Jr, Earl J" uniqKey="Brewer Jr E" first="Earl J." last="Brewer Jr.">Earl J. Brewer Jr.</name></region><name sortKey="Giannini, Edward H" sort="Giannini, Edward H" uniqKey="Giannini E" first="Edward H." last="Giannini">Edward H. Giannini</name><name sortKey="Milam, John D" sort="Milam, John D" uniqKey="Milam J" first="John D." last="Milam">John D. Milam</name><name sortKey="Nickeson Jr, Robert W" sort="Nickeson Jr, Robert W" uniqKey="Nickeson Jr R" first="Robert W." last="Nickeson Jr.">Robert W. Nickeson Jr.</name><name sortKey="Person, Donald A" sort="Person, Donald A" uniqKey="Person D" first="Donald A." last="Person">Donald A. Person</name><name sortKey="Rossen, Roger D" sort="Rossen, Roger D" uniqKey="Rossen R" first="Roger D." last="Rossen">Roger D. Rossen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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