TY  - JOUR
IS  - 8
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
TI  - Therapeutic plasma exchange in paediatric neurology: a critical review and proposed treatment algorithm
VL  - 60
AV  - public
Y1  - 2018/08//
SP  - 765
EP  - 779
JF  - Developmental Medicine & Child Neurology
A1  - Eyre, M
A1  - Hacohen, Y
A1  - Barton, C
A1  - Hemingway, C
A1  - Lim, M
N2  - Therapeutic plasma exchange (TPE) has been a key immunotherapeutic strategy in numerous neurological syndromes, predominantly during the acute phase of illness. This paper reviews the indications, strength of evidence, and safety of TPE in children with neurological conditions. The rarity of these immune conditions in children, alongside an often incomplete understanding of their pathobiology, has limited the development of a robust scientific rationale for TPE therapy and the feasibility of conducting larger controlled trials. TPE continues to be used, but is a costly therapy with common adverse effects. Uncertainty remains over how to compare the different TPE methods, the optimal dosage of therapy, and monitoring and integration of TPE with other immunotherapies. Further studies are also required to define the indications and benefits of TPE and assess evolving technologies such as immunoadsorption. /

What this paper adds: Studies investigating therapeutic plasma exchange (TPE) are small and mainly uncontrolled.
They provide evidence for the efficacy of TPE in childhood neuro?inflammatory conditions.
TPE is generally well tolerated provided key adverse effects are anticipated and avoided.
Systematic dosing and objective assessment of treatment effect should be priorities for future research.
ID  - discovery10087936
PB  - WILEY
UR  - https://doi.org/10.1111/dmcn.13925
ER  -