I.V. Immunoglobulin and Plasma Exchange

[Sangye]

Actually, these two treatments are exactly the opposite. Plasma exchange attempts to remove offending antibodies; IV immunogloblin supplements antibodies that are in short supply. It is used with certain acute infections and some autoimmune diseases, like Kawasaki disease. I have never heard of its use with WG and similar diseases, as they are associated with too many antibodies (ANCA).

Al

I asked Dr Seo why some people have gotten IVIG at times. He said it has nothing to do with treating the Wegs, and is only given if they become too immune-compromised.

[delorisdoe]

I was only given them when I became too immune compromised. My doctor gave it to me for exactly why dr seo said. It took a lot of convincing from all of you though to convince me that it was not the reason for my abrupt remission.

p.s. sangye...i just ordered the book off of amazon used for 3 bucks. Pretty good considering I almost ordered it from my local book store for 17 bucks plus tax.

[watersedge]

Leigh mentioned something about plasma exchange involving removing your own blood. Would dialysis do the same thing? Sorry, I am a bit of a dope when it comes to all this medical stuff. Thanks for all your replies.

[Sangye]

No, dialysis just replicates what the kidneys should be doing-- removing waste products from the blood.

Plasma exchange doesn't really replicate a bodily process.

[Al]

No, dialysis just replicates what the kidneys should be doing-- removing waste products from the blood.

Plasma exchange doesn't really replicate a bodily process.

Plasma exchange is sort of like the old dairy process of separating the curds from the whey. It takes out some of the blood, separates out and tosses the plasma (the fluid part that hast the free-floating antibodies), adds the chunky parts of the blood (all the red stuff) to fresh plasma, and puts it back in. Six or seven times through this process usually takes care of a large percentage of the antibodies.

Al

[watersedge]

Thanks everyone. I have another question I wanted to ask. I've read on another thread somewhere that it takes about a month for cyclophosphamide to kick in when you take it first but if you are very ill and have kidney involvement, what is dealing with the anca's continually attacking the blood vessels in the meantime especially if you are deteriorating rapidly and waiting for the cyclo to work to full effect? I know the steroids reduce inflammation, does it also deal with the offending antibodies?

[pberggren1]

The cyclo kicks in right away the first day with oral or IV, but the full effect usually takes about a week to 3 weeks depending on dose, severity of disease, and amount of pred.

[drz]

Some studies on plasma exchange indicate it is very helpful:

Combination therapy with cyclophosphamide and prednisolone is widely used for renal vasculitis and leads to remission in over 90% of patients. Those presenting with advanced renal failure, however, have poorer outcomes with only 50% surviving with independent renal function at 1 year..

In a retrospective review of patients with ANCA-associated vasculitis and pulmonary hemorrhage, however, 20 patients received methylprednisolone, plasma exchange and cyclophosphamide. All patients had resolution of their pulmonary hemorrhage and 50% showed improvement in renal function. There were no complications of therapy.

ANCA-associated vasculitis, which includes Wegener’s granulomatosis and microscopic polyangiitis, accounts for 80% of patients with rapidly progressive glomerulonephritis.

[watersedge]

Drz, this is what I am trying to get to the bottom of in my head by eliminating every other possible question I can think of but it keeps coming back to the same question, especially with the kidney involvement, WHY DIDN'T THEY GIVE HIM PLASMA EXCHANGE??? I had never heard of it until I came on this forum and read how it helped so many people, how I wish I had found this site in time, maybe I would have know the right questions to ask the doctors, sorry, I think I am slowly going mad.

[watersedge]

Thank you also Phil.