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Al-Azhar Medical Journal
Article . 2021 . Peer-reviewed
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PREDICTORS OF RESPONSE TO PLASMAPHERESIS IN AUTOIMMUNE NEUROPATHIES

Authors: Yasser El-Sayed Mukhtar; Tarek Ibrahim Mnecie; Hassan Kawashti Gad; Mohammed Ahmed Zaki;

PREDICTORS OF RESPONSE TO PLASMAPHERESIS IN AUTOIMMUNE NEUROPATHIES

Abstract

Background: Immune-mediated neuropathies represent a significant portion of cases encountered by neurologists. The scope of responsive neuropathies, the extent of response to plasmapheresis and its predictors varies widely. Objective: To recognize predictors of response to plasmapheresis in autoimmune-neuropathies. Patients and Methods: Seventy-six subjects; 61 Guillain-Barre syndrome (GBS) patients and 15 chronic inflammatory demyelinating polyneuropathy (CIDP) patients were recruited and evaluated using Medical Research Council sum score (MRCSS) and Modified Neuropathy Disability Score (NDS); on admission, 2 weeks and 3 months after six session of plasmapheresis. Different clinical, laboratory and neurophysiological variables were evaluated as possible predictors of response. Results: Of 61GBS patients, after 3 months, 41% (n=25) of them were poor-responders to plasmapheresis (<50% increase in MRCSS), and 59% (n=36) were good-responders. Older age, higher MRCSS on admission, lower NDS on admission, cyto-albuminous dissociation, electro-physiological evidence of axonal nerve affection and low NLR were predictors for poor response to plasmapheresis in GBS patients. Of 15 CIDP patients, after 3 months, 53.3% (n=8) of them were poor-responders to plasmapheresis (< 30% increase in MRCSS), and 46.7% (n=7) were good-responders. Higher MRCSS on admission, low CMAP amplitude, low MCV and long time between onset of the health problem and start of plasmapheresis were predictors for poor response to plasmapheresis in CIDP patients. Conclusion: Response to plasmapheresis in autoimmune neuropathies is variables and depends on several factors that can predict it.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
bronze