Plasmapheresis and Intravenous Immunoglobin Clinical Uses, Potential Complications and Long-Term Health Effects

Plasmapheresis is a therapeutic tool used to treat a wide range of disease processes, and in which the priority aim is to ensure sufficient plasma exchange to reduce or eliminate symptoms resulting from the action of pathogenic elements vehiculised in the plasma. Scientific selective apheresis with principles of evidence-based medicine involves the application of one of the oldest therapeutic modalities (bleeding), widely used between the fourth century B.C. and the second industrial revolution. This book provides information on the use of plasmapheresis during pregnancy; therapeutic use of autologous plasma for the treatment of dry eye disease; and therapeutic plasma exchange in the neurological setting. It also discusses intravenous immunoglobulins. During the past decades intravenous immunoglobulins (IVIG) have gained more and more popularity for the treatment of a wide range of diseases and conditions. This treatment is extensively used in immune deficits, autoimmune thrombocytopenia, Kawasaki's disease, for the prevention of infectious complications due to hypogammaglobulinaemia secondary to myeloma, chronic lymphatic leukaemia and post-bone marrow and stem cell transplantation, in Guillain-Barre syndrome, etc. IV-Ig is obtained from the plasma of healthy blood donors and contains normal, polyclonal, polyspecific immunoglobins (Ig), mostly consisting of intact IgG. These antibodies are directed against non-self-antigens, self-antigens (natural autoantibodies), and other antibodies (idiotypic antibodies). The administration of intravenous immunoglobulin (IVIG) is generally safe and well tolerated. However, the treatment of autoimmune disorders usually requires high dose therapy (1-2 g/kg) that may result in a greater frequency of side effects and adverse events. This book discusses several topics including the clinical application of intravenous immunoglobulins in autoimmune mediated ocular inflammatory diseases; complications of intravenous immunoglobulin therapy; clinical uses; and side effects.