[Plasmapheresis, a safe treatment when applied to the correct indication and with awareness of the complications]. / Plasmaferese: veilig bij een goede indicatiestelling en kennis van de complicaties.

Plasmapheresis is an extracorporeal technique used to remove pathogenic macromolecules from the circulation, particularly autoantibodies. This is illustrated in 2 female patients. The first patient, aged 61 years, was treated successfully with non-selective plasmapheresis for acute humoral rejection shortly after receiving a renal allograft. In the second patient, aged 82 years, plasmapheresis for refractory myasthenia gravis had to be stopped because of bradycardia and hypotension during the procedure. She was treated successfully with immunoglobulins. Plasmapheresis is used to treat neurological, renal, haematological and systemic disorders. In nonselective plasmapheresis, the plasma is replaced with saline and albumin or donor plasma. In selective plasmapheresis a highly selective filter is used to remove a specific, pathogenic macromolecule. Adverse effects of the treatment include disturbances of the acid-base equilibrium or the coagulation, and allergic reactions. Most of these complications, however, can nowadays be avoided.

[Plasmapheresis: technique, complications and indications]. / La plasmaphérèse: technique, complications et indications.

Plasmapheresis is an extracorporeal technique used to remove pathogenic macromolecules from the plasma. Plasmapheresis is used to treat neurological, renal, hematological as well as systemic diseases, which explains why many different specialties in medicine can be involved. Plasmapheresis has evolved in forty years into a frequently used, relatively safe procedure. Nowadays a large spectrum of different techniques exists, each with its own possible complications. In this article we will give an overview of these different techniques, their complications and indications, in order to familiarize the reader with this fascinating treatment.

[IgA nephropathy: what you have need to know in 2005]. / Maladie de Berger: que faut-il savoir en 2005?

Although considered as a benign glomerulopathy, IgA nephropathy (IgAN) is now a well-known cause of end-stage renal disease (ESRD). Fifty percent of people suffering from IgAN developp renal insufficiency and 20 to 30% may reach ESRD after 20 to 25 years of evolution. ACEI is indicated to obtain a thigh control of blood pressure and to reduce proteinuria. Corticosteroids alone or in association with immunosuppressants are indicated for agressive, proliferative form of the disease or when there is an unfavorable outcome despite symptomatic treatment.