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More Uses for Apheresis FREE

H. Taelman, MD; L. Muylle, MD
JAMA. 1985;254(15):2064-2064. doi:10.1001/jama.1985.03360150040016
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To the Editor.—  We read with great interest the report of the American Medical Association Panel on Therapeutic Plasmapheresis1 and were surprised that loiasis with hypermicrofilaremia and overwhelming Plasmodium falciparum malaria were not included in the list of indications for apheresis.At least two reports2,3 give strong evidence for the efficiency of apheresis in the removal of Loa loa microfilaria. This well-tolerated procedure is particularly useful in avoiding severe toxic reactions—in some cases fatal—occurring in patients with a high microfilarial load being treated with diethylcarbamazine.Similarly, automated erythrocyte exchange transfusion has proved effective in rapidly reducing high P falciparum blood load. Erythrocytapheresis combined with transfusion of packed red blood cells using a flow cell separator and specific chemotherapy should be strongly advocated in cases of malaria with either cerebral, renal, pulmonary, or hemostatic complications and parasitemia in excess of 10%.4-9Because apheresis may have a useful, and

REFERENCES

Council on Scientific Affairs:  Current status of plasmapheresis and related techniques: Report of the AMA Panel on Therapeutic Plasmapheresis . JAMA 1985;;253:819-825.
Muylle L, Taelman H, Moldenhauer R, et al:  Usefulness of apheresis to extract microfilarias in management of loiasis . Br Med J 1983;;287:519-520.
Saeed AA, Green PJ, Naoror M, et al:  Loa loa: The use of a blood cell separator to reduce microfilaraemia before specific therapy . J Infect 1984;;9:160-166.
Gyr K, Speck B, Ritz R, et al:  Zerebrale Malaria tropica mit Schwarzwasserfieber: Ein aktuelles diagnostisches und therapeutisches Problem . Schweiz Med Wochenschr 1974;;104:1628-1630.
Neilson RL, Kohler RB, Chin W, et al:  The use of exchange transfusions: A potentially useful adjunct in the treatment of fulminant falciparum malaria . Am J Med Sci 1979;;277:325-329.
Roncoroni AJ, Martino OA:  Therapeutic use of exchange transfusion in malaria . Am J Trop Med Hyg 1979;;28:440-444.
Yarrisch RL, Jonas JS, Nosanchuk JS, et al:  Transfusion malaria: Treatment with exchange transfusion after delayed diagnosis . Arch Intern Med 1982;;42:187-188.
Kramer SL, Campbell CC, Mancrieff RE:  Fulminant Plasmodium falciparum infection treated with exchange blood transfusion . JAMA 1983;;249:244-245.
Files JC, Case CJ, Marrison FS:  Automated erythrocyte exchange in fulminant P falciparum malaria . Ann Intern Med 1984;;100:396-397.

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Council on Scientific Affairs:  Current status of plasmapheresis and related techniques: Report of the AMA Panel on Therapeutic Plasmapheresis . JAMA 1985;;253:819-825.
Muylle L, Taelman H, Moldenhauer R, et al:  Usefulness of apheresis to extract microfilarias in management of loiasis . Br Med J 1983;;287:519-520.
Saeed AA, Green PJ, Naoror M, et al:  Loa loa: The use of a blood cell separator to reduce microfilaraemia before specific therapy . J Infect 1984;;9:160-166.
Gyr K, Speck B, Ritz R, et al:  Zerebrale Malaria tropica mit Schwarzwasserfieber: Ein aktuelles diagnostisches und therapeutisches Problem . Schweiz Med Wochenschr 1974;;104:1628-1630.
Neilson RL, Kohler RB, Chin W, et al:  The use of exchange transfusions: A potentially useful adjunct in the treatment of fulminant falciparum malaria . Am J Med Sci 1979;;277:325-329.
Roncoroni AJ, Martino OA:  Therapeutic use of exchange transfusion in malaria . Am J Trop Med Hyg 1979;;28:440-444.
Yarrisch RL, Jonas JS, Nosanchuk JS, et al:  Transfusion malaria: Treatment with exchange transfusion after delayed diagnosis . Arch Intern Med 1982;;42:187-188.
Kramer SL, Campbell CC, Mancrieff RE:  Fulminant Plasmodium falciparum infection treated with exchange blood transfusion . JAMA 1983;;249:244-245.
Files JC, Case CJ, Marrison FS:  Automated erythrocyte exchange in fulminant P falciparum malaria . Ann Intern Med 1984;;100:396-397.
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