Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disorder that affects peripheral nerves. Total plasma exchange can provide clinical improvement by removing the autoantibodies.
Patient selection: CIDP
Total plasma exchange is used to remove autoantibodies. This is performed in conjunction with rituximab or other immunosuppression, which reduces production of the autoantibody. Plasma exchange alone provides only temporary relief.
Target volume: 1.5 times total plasma volume
Replacement fluid: albumin
Frequency: 2-3 times per week initially, then taper as needed
A delay in therapy may be associated with demyelination and axonal degeneration, which results in permanent disability.
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