Therapeutic Plasma Exchange for Treating Pediatric Neurological Diseases

Objective: Therapeutic plasma exchange (TPE) is performed in various neurological, hematological, renal and autoimmune diseases. This study was conducted to determine the indications, efficacy, safety and complications of TPE in pediatric autoimmune neurological diseases.
Methods: In this study, patients who were hospitalized in the pediatric intensive care unit of a tertiary university hospital between January 2017 and December 2021 and underwent TPE due to neurological diseases were evaluated retrospectively.
Results: A total of 20 patients were included in the study. Their ages ranged from 6 to 237 months, with a mean age of 63.16±183.12 months. Neurological TPE indications of the patients were autoimmune encephalitis (50%, n=10), Guillain-Barre Syndrome (45%, n=9) and Acute Demyelinating Encephalomyelitis (6.7%, n=1), respectively. Catheter occlusion was observed in 2 (10%) patients, allergic reaction in 1 (5%) patient, and hypotension in 1 (5%) patient as complications of TPE. Muscle strength of patients with GBS was evaluated according to the Medical Research Council scale before transfer to the service. It was determined that the score increased from 0 to 1 in two patients, from 0 to 3 in three patients, and from 1 to 5 in four patients. In 9 of the patients diagnosed with encephalitis, regression of acute phase reactants and improvement in neurological evaluation were observed.
Conclusion: When TPE is applied with appropriate indications and by an experienced team in pediatric neurological diseases, treatment results can are satisfactory, its effectiveness increases and the complication rate decreases.