Plasma Exchange
Also written as PE.
Nephritic entities: PSGN in children is self‑limited with >90 % full recovery; RPGN carries a high risk of ESRD unless rapid immunosuppression and plasma exchange are instituted.
What our notes say
- Nephritic entities: PSGN in children is self‑limited with >90 % full recovery; RPGN carries a high risk of ESRD unless rapid immunosuppression and plasma exchange are instituted. (Nephrotic and nephritic syndromes)
- | Severe renal impairment (eGFR < 30 ml/min) or rapidly rising creatinine | Initiate urgent plasma exchange (if ANCA‑associated) and start high‑dose intravenous glucocorticoid pulse | Removes pathogenic antibodies and controls inflammation while definitive therapy is arranged | (Vasculitis)
- A provisional diagnosis of Thrombotic Thrombocytopenic Purpura (TTP) is made and the patient is referred for plasma exchange following placement of central line. (Haematology paper 1 Past Papers — Past Paper Questions & Answers)
- RPGN and lupus nephritis: an emergency: high-dose steroids, cyclophosphamide, plasma exchange for anti-GBM, and renal support. (Nephrotic and nephritic syndromes)
- | ADAMTS13 activity (if TMA suspected) | Distinguish TTP | Severely reduced activity supports TTP; requires plasma exchange. | (Haemolytic anaemia)
- Definitive therapy directed at the identified mechanism (immunosuppression for AIHA, avoidance of oxidants for G6PD, antimalarials for malaria, splenectomy for hereditary spherocytosis when indicated, plasma exchange for TTP). (Haemolytic anaemia)
Study material on Plasma Exchange
- Myasthenia gravis
- Vasculitis
- Peripheral neuropathy and Guillain-Barre syndrome
- Hematopathology MCQs & Essays: MBChB Exam Revision Guide
- Nephrotic and nephritic syndromes
- Platelet Disorders