Authors: Rolf Bambauer, Ralf Schiel, Octavio J. Salgado, Richard Straube.
Therapeutic plasma exchange with hollow fiber modules is used since 45 years and in combination with immunosuppressive therapies and/or human monoclonal antibodies a steady increase in survival rates over the last decades. Therapeutic apheresis is accepted as supportive therapy in all severe neurological diseases such as in acute or chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, multiple sclerosis, Refuse’s disease, Rasmussen encephalitis and others. Infection with COVID-19 can exacerbate and aggravate the neurological diseases due to autoimmune etiology. The therapy is the same like for the neurological diseases. Other therapy strategies are different human monoclonal antibodies with or without therapeutic apheresis. The knowledge of immunology and molecular biology of different neurological diseases are discussed in relation to the rationale for apheresis therapy and its place with other modern therapy strategies, and the pathogenetically aspects are demonstrated. Therapeutic apheresis has shown to effectively remove all autoantibodies and others toxins from blood and lead to rapid clinical improvement. The guidelines of the Apheresis Application Committee of the American Society for Apheresis are cited for neurological diseases, which could be treated with therapeutic apheresis.
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