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1.
Ther Apher Dial ; 28(3): 453-459, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38173128

RESUMEN

INTRODUCTION: A novel LDL (low-density lipoprotein) apheresis therapeutic option, Rheocarna, has garnered attention as an alternative therapy for chronic limb-threating ischemia (CLTI). Bradykinin-mediated vasodilation is involved in the effects of LDL apheresis and a decrease in blood pressure (BP), but the changes in bradykinin concentration during Rheocarna therapy are unknown. METHODS: The study involved patients with CLTI treated with Rheocarna at our hospital, from April 2022 to August 2023. RESULTS: After Rheocarna therapy, skin ulcers improved in 80% of the patients. Circuit coagulation was observed in two patients with high fibrinogen levels. A decrease in BP was observed at approximately the same time when the bradykinin concentration peaked. The peak bradykinin concentration in a patient undergoing hemodialysis at the same time was considerably lower than that in the other patients. CONCLUSION: This is the first report on the changes in bradykinin concentration under Rheocarna therapy.


Asunto(s)
Presión Sanguínea , Bradiquinina , Humanos , Masculino , Femenino , Anciano , Presión Sanguínea/efectos de los fármacos , Persona de Mediana Edad , Eliminación de Componentes Sanguíneos/métodos , Isquemia , Lipoproteínas LDL/sangre
2.
Ther Apher Dial ; 28(3): 432-441, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38225794

RESUMEN

INTRODUCTION: Clinically amyopathic dermatomyositis (CADM) with anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab) with rapidly progressive interstitial lung disease (RP-ILD) is often refractory for intensive immunosuppression. In this study, we verified the effectiveness and safety of plasma exchange (PEx) for this lethal disease. METHODS: We retrospectively examined the clinical course and adverse effect (AE) of 12 patients with anti-MDA5 Ab-positive CADM between January 2017 and December 2021 in our hospital. RESULTS: Five out of six patients treated with simple PEx using fresh frozen plasma or 5% albumin survived with or without home oxygen therapy. Multiple PEx (15-20 times) were required to achieve satisfactory improvement as well as remission of CADM. The AEs caused by PEx were resolved using conventional methods. CONCLUSION: PEx might be a promising option for controlling the disease activity of anti-MDA5 Ab-positive CADM with severe RP-ILD and may contribute to better survival.


Asunto(s)
Dermatomiositis , Helicasa Inducida por Interferón IFIH1 , Enfermedades Pulmonares Intersticiales , Intercambio Plasmático , Humanos , Enfermedades Pulmonares Intersticiales/terapia , Enfermedades Pulmonares Intersticiales/inmunología , Dermatomiositis/inmunología , Dermatomiositis/terapia , Dermatomiositis/complicaciones , Intercambio Plasmático/métodos , Masculino , Femenino , Persona de Mediana Edad , Helicasa Inducida por Interferón IFIH1/inmunología , Estudios Retrospectivos , Adulto , Anciano , Resultado del Tratamiento , Progresión de la Enfermedad , Autoanticuerpos/sangre
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