Source: International Congress 2014 – Clinical management of interstitial lung diseases and vasculitis
Disease area: Interstitial lung diseases

Abstract

Aim: To estimate of plasmapheresis (P) efficiency in patients (pts) with PS.Methods. The retrospective analysis of clinical, radiologic, functional, laboratory data was performed after 10 years observation of pts with PS. The 1^st group (58 pts) was subjected to P, the 2^nd group (54 pts) did not receive P. Glucocorticosteroid (GCS) treatment was administered according to ATS\ERS recommendations. Serum samples were tested for TNF-ag, IL-10,RAIL, and TGF-b1 by ELISA before and after the plasmapheresis. 37 healthy volunteers were examined as a control group. P was used in 6 months. Bone Mineral Density (BMD) was measured by DEXA.Results. After directly P decrease (p<0.05) in proinflammatory cytokines levels: TNF-a, IFN-g and increase (p<0.05) in IL-10,RAIL, and TGF-b1 were revealed, that explains the pathogenetic mechanisms of therapeutic action of P. After 10 years clinical improvement in 40 (68.9%) ptsof 1^st group and only 21 pts (38.8%) of 2^nd group was observed. We found tendency to improvement of average values PFTs in pts receiving P. In 1^st group favorable course was observed in 38 pts (65 %), relapsing – in 11 (19%), stable – in 5 (9 %), progressive – in 4 pts (7%). In 2^nd group favorable course was observed in 24 pts (45 %), relapsing – in 18 (33%), stable – 4 (7%), progressive – 8 pts (15%). P has been found to maintain improvement and stable remission with low-dose GCS therapy. BMD decreased significantly more often than subjects in 2^nd group (OR=3.87, p<0.01).Conclusion. This investigation showed that plasmapheresis effectiveness in complex treatment of PS pts leads to improvement and stabilization of pathologic process and permits to decrease dose of GCS in some cases.

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Citations should be made in the following way:
O. Baranova, V. Voinov, O. Baklanova (Saint-Petersburg, Russian Federation). 30 years experience of plasmapheresis using in complex treatment of pulmonary sarcoidosis (PS). Eur Respir J 2014; 44: Suppl. 58, 4510

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