Subject(s)
Blood , Plasma Exchange , Ultrafiltration/methods , Vasculitis/therapy , Adult , Aged , Cold Temperature , Female , Humans , Male , Middle AgedABSTRACT
The technique of cryofiltration has been applied in the treatment of cryoglobulinemia. Good clinical improvement has been demonstrated accompanied by decreases of cryoglobulin levels. Three treatments in a week produced transient improvement of clinical symptoms and reduction of cryoglobulin levels. Follow-up treatments performed at adequate frequency and volume processed maintained relief of symptoms and serologic improvement. The cryofilter demonstrates good selectivity for cryoglobulin removal in cryogel, confirmed by electrophoretic analysis of both the cryogel filtrate from the cryofilter used clinically. Plasma cryofiltration appears to be a safe alternative to plasma exchange, requiring no replacement fluids.
Subject(s)
Cryoglobulins/metabolism , Plasma , Ultrafiltration/methods , Aged , Antigen-Antibody Complex/analysis , Cold Temperature , Female , Humans , Middle Aged , Molecular WeightSubject(s)
Biocompatible Materials , Cholangitis/therapy , Membranes, Artificial , Plasmapheresis/instrumentation , Adult , Animals , Complement Activation , Dogs , Hemolysis , Humans , Leukocyte Count , Male , SclerosisABSTRACT
This study has shown that cryofilter plugging correlates with pretreatment pathologic macromolecule concentrations (e.g. rheumatoid factor and immune complexes) in the treatment of patients with rheumatoid arthritis. Pathologic macromolecules are concentrated relative to albumin in the cryogel. Molecular aggregation in the cryogel depends upon heparin concentration, exhibiting maximum aggregation in a specific range of heparin concentrations. Molecular aggregation in cryogel increases with decreasing temperature. In the use of cryofiltration in over 50 rheumatoid arthritis patients, clinical improvement has accompanied the removal of cryogel and the pathologic macromolecules it contains. Filter plugging or cryogel formation may be indicators of disease activity. Formation of cryogel is variable depending upon type of disease, severity of disease, temperature, heparin concentration, and membrane structure. These factors are important parameters to consider to optimize conditions for removal of cryogel and for continuing improvement of plasma therapeutic techniques for the treatment of rheumatoid arthritis.
