Health Technology BriefFor patients with corticosteroid refractory transverse myelitis acute transverse myelitis, therapeutic plasma exchange PLEX is often initiated as a second-line therapy corticosteroid refractory transverse myelitis patients who demonstrate an insufficient response to intravenous IV corticosteroids, but may also be initiated at first presentation. PLEX is an extracorporeal technique based on the separation of plasma from the transferse elements of the blood, the purpose of which is to remove the plasma, which has antibodies or other substances that may be producing disease, particularly those of the humoral immune system. These substances may be removed through centrifugal separation or a membrane separation filter. Centrifugal apheresis devices can generally be used via peripheral venous access but may require central venous access. The plasma layer is removed and discarded and the low testosterone levels cells are mixed with a sterile plasma substitute e.
Plasma Exchange for Treatment of Steroid-Refractory Transverse Myelitis : Hayes, Inc.
Incomplete transverse myelitis ITM of unknown origin is associated with high rates of morbidity and mortality. This prospective, open-label study was undertaken to determine whether antituberculous treatment ATT might help patients with ITM whose condition continues to deteriorate despite receiving IV methylprednisolone treatment.
The study consisted of 67 patients with steroid-refractory ITM in whom Mycobacterium tuberculosis MTB was suspected clinically and in whom other known causes of myelopathy were excluded. The study occurred from January to June Patients underwent trial chemotherapy with ATT. Of the 67 patients enrolled, 51 were assessed and 16 withdrew. The results from this prospective study provide beneficial clinical and MRI data on the efficacy of ATT in ITM patients and suggests mycobacteria may be an important and neglected cause of myelitis.
National Center for Biotechnology Information , U. Didn't get the message? Add to My Bibliography. Generate a file for use with external citation management software. Epub Feb 7. Abstract Incomplete transverse myelitis ITM of unknown origin is associated with high rates of morbidity and mortality. Images from this publication. See all images 8 Free text. A year-old woman was admitted due to the progressive weakness and parasthesia in both legs with voiding problem for 3 months.
After 2-year ATT, her situation improved with good recovery of spinal function. The MRI changes are as follows: A small cavity is visible on T8, and increased signal intensity still exists below T9. A year-old female developed paraplegia and paresthesias in August ; weakness slowly worsened. Pulse methylprednisolone and IVIG were initiated with no resolution; she continued to deteriorate.
After 2-year ATT, her situation fully recovered. A year-old female suffered from tetraparesis and frequently paroxysmal tics of extremities for 3 months. ATT treatment quickly improved her symptoms. After 2-year ATT, she fully recovered without visible symptoms. A year-old woman had tetraparesis, C3 sensory level, and urinary incontinence for five months. Pulse methylprednisolone and IVIG were initiated with no resolution. However, ATT greatly improved her condition.
A year-old female was admitted due to progressive paraparesis, paresthesias, and urinary retention for 2 months. After 2-year of ATT, her situation improved. A year-old male suffered from left paraparesis and paresthesias for 1 month. MRI of the cervical spinal cord revealed a demyelinating lesion in T2-weighted images extending from C4 to C7. A year-old female suffered from progressive paraparesis and paresthesias for 1 month.