Document Detail


Intensive plasma exchange for severe autoimmune hemolytic anemia in a four-month-old infant.
MedLine Citation:
PMID:  10611631     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report the smallest infant (7.5 kg) to receive intensive plasma exchange (52 PEs) therapy as treatment of autoimmune hemolytic anemia (AIHA). PE temporarily reduces circulating autoantibody levels and can be an effective adjunctive therapy with corticosteroids and cytotoxic drugs or other immuno-suppressants. Although his clinical course was prolonged and complicated by cytomegalovirus infection with spontaneous perforation of his colon, his recovery was complete. He has remained healthy for more than 2 years. Because of his small size, calcium gluconate was added to replacement fluids and calcium levels closely monitored. The apheresis machine and tubing were routinely primed with red blood cells and FFP substituted for 5% human albumin during the second half of all procedures to maintain adequate levels of procoagulant. Our experience suggests that intensive PE is helpful in controlling severe AIHA and should be considered even for very small patients.
Authors:
L J McCarthy; C F Danielson; C Fernandez; E Skipworth; C A Limiac; T Prahlow; J Goldman
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical apheresis     Volume:  14     ISSN:  0733-2459     ISO Abbreviation:  J Clin Apher     Publication Date:  1999  
Date Detail:
Created Date:  2000-02-04     Completed Date:  2000-02-04     Revised Date:  2005-07-26    
Medline Journal Info:
Nlm Unique ID:  8216305     Medline TA:  J Clin Apher     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  190-2     Citation Subset:  IM    
Copyright Information:
Copyright 1999 Wiley-Liss, Inc.
Affiliation:
Indiana University Medical Center, Indianapolis, Indiana 46202, USA. lmmcarth@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Anemia, Hemolytic, Autoimmune / complications,  drug therapy,  surgery,  therapy*
Autoimmune Diseases / complications,  drug therapy,  surgery,  therapy*
Calcium Gluconate / therapeutic use
Combined Modality Therapy
Cytomegalovirus Infections / complications
Humans
Immunoglobulins, Intravenous / therapeutic use
Immunosuppressive Agents / adverse effects,  therapeutic use
Infant
Intestinal Perforation / complications
Male
Methylprednisolone / therapeutic use
Plasma Exchange*
Sigmoid Diseases / complications
Splenectomy
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Immunoglobulins, Intravenous; 0/Immunosuppressive Agents; 299-28-5/Calcium Gluconate; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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