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J Clin Apher. 2015 Oct;30(5):259-64. doi: 10.1002/jca.21370. Epub 2014 Oct 29.

Role of therapeutic apheresis in infectious and inflammatory diseases: Current knowledge and unanswered questions.

Author information

1
Blood Bank Medical Director, Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts.
2
Associate Professor of Pathology, Harvard Medical School, Boston, Massachusetts.
3
Medical Director Transfusion and Apheresis Medicine Services, Baystate Medical Center, Springfield, Massachusetts.
4
Assistant Professor of Anatomic and Clinical Pathology, Tufts University School of Medicine, Boston, Massachusetts.
5
Assistant Professor of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
6
Associate Professor of Medicine, University of Pittsburgh, Pennsylvania.
7
Department of Medicine, University of Pittsburgh, Pennsylvania.
8
Division of Hematology-Oncology, University of Pittsburgh, Pennsylvania.
9
The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania.
10
Senior Research Scientist in Epidemiology, Medicine and Pediatrics, Lecturer in Epidemiology, Yale School of Public Health, New Haven, Connecticut.
11
Assistant Professor, Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina.

Abstract

Apheresis can remove pathogens and mediators that contribute to pathogenic inflammatory responses in diseases not generally considered to be "Hematologic." Erythrocytapheresis can remove intracellular pathogens such as Babesiosis. Plasmapheresis can remove mediators of the inflammatory response in conditions such as sepsis, chronic autoimmune urticaria and malignant pertussis. Leukapheresis can remove potentially harmful leukocytes in Crohn's Disease and malignant pertussis. While apheresis can remove all of these substances, the clinical efficacy and pathophysiologic changes that occur during apheresis in these conditions are largely unknown. Hence, the clinical utility of apheresis in these conditions is largely unknown and research in these areas has the potential to benefit many patients with a variety of diseases.

KEYWORDS:

Babesiosis; Crohn's disease; chronic idiopathic urticaria; pertussis; sepsis

PMID:
25351167
DOI:
10.1002/jca.21370
[Indexed for MEDLINE]
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