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An unexpected complication following immunoadsorption with a staphylococcal protein a column

✍ Scribed by Douglas W. Huestis; Robert M. Rifkin; Brian G. M. Durie; William A. Sibley; Mehraboon Irani

Publisher
John Wiley and Sons
Year
1992
Tongue
English
Weight
304 KB
Volume
7
Category
Article
ISSN
0733-2459

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✦ Synopsis

Abstract

Extracorporeal immune adsorption with staphylococcal protein A (SPA) columns can remove immune complexes and immunoglobulins in the treatment of a variety of diseases. We present the case of an elderly man with neuropathy associated with monoclonal gammopathy, treated by 3 on‐line SPA procedures. At the completion of these treatments his neuropathy relapsed, progressing to near‐total paralysis. Return to a baseline clinical status required several months. The reason for this severe relapse is not clear. Possible explanations include SPA activation of T‐lymphocytes, with release of gamma interferon and increased antigen recognition, or removal of an anti‐idiotype control mechanism. We advise caution in the application of immunoadsorption to conditions in which it has not yet been evaluated. © 1992 Wiley‐Liss, Inc.

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