Efficacy of plasma exchange in the treatment of autoimmune hemolytic anemia in children
10.3760/cma.j.issn.1673-4912.2022.09.006
- VernacularTitle:血浆置换治疗儿童自身免疫性溶血性贫血疗效分析
- Author:
Yi MENG
1
;
Yubin WU
;
Yefei LEI
;
Qiang QU
;
Zhihong HAO
;
Li YU
;
Yao ZHANG
;
Ping ZHOU
;
Sijia ZHANG
;
Xuemei LIU
;
Hongxia ZHANG
;
Yanyan PAN
;
Liqun DONG
;
Yuhong TAO
;
Lijuan ZHANG
;
Jianjiang ZHANG
;
Limin JIA
;
Junmei LIU
;
Cuihua LIU
;
Hongjiang LI
;
Guangbo LI
Author Information
1. 中国医科大学附属盛京医院小儿肾脏风湿免疫科，沈阳 110004
- Keywords:
Blood purification;
Autoimmune hemolytic anemia;
Children
- From:
Chinese Pediatric Emergency Medicine
2022;29(9):691-695
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of plasma exchange(PE) in the treatment of autoimmune hemolytic anemia in children.Methods:The data from 8 hospitals in China during November 2014 to April 2017 were collected, and the clinical characteristics of PE in children with AHA were analyzed retrospectively.Results:A total of 21 children with AHA were included in the study, including 17 cases from PICU and 4 cases from pediatric kidney ward, with 11 boys and 10 girls, and the median age was 3.64(0.25, 11.10)years old, and median hospital stay was 12(4, 45)days.There were 15 cases(71.4%) with infection, 2 cases(9.5%)with autoimmune diseases, 4 cases(19.0%) with unknown.Consciousness disturbance occurred in 4 patients before replacement and recovered to normal after PE.The volume of blood decreased in two cases(9.5%) and completely relieved.There were 20 cases of anemia (95.2%), 15 cases were normal after PE, and 5 cases were improved.Jaundice occurred in 18 cases (85.7%), 12 cases were normal after PE, 6 cases were improved.Hepatosplenomegaly was found in 11 cases, 10 cases were normal after PE, 1 case was improved.After PE, the hemoglobin and red blood cell count increased, while the total bilirubin, indirect bilirubin, urea nitrogen and lactate dehydrogenase decreased, there were significant differences between pre-and post-replacement ( P<0.05). Only 1 case had allergic reaction, which was improved after symptomatic treatment, and PE was continued.After PE, 2 cases (9.5%) had complete remission, 16 cases (76.2%) had partial remission and 3 cases (14.3%) had been discharged. Conclusion:PE therapy can obviously improve the clinical symptoms and laboratory indexes of children with AHA who have failed to respond to conservative treatment.It can be used as a treatment measure for children with severe AHA and has a good safety.
