ABSTRACT
The first experiences with therapeutic plasma exchange (PE) involved the removal of plasma for the specific treatment of hyperviscosity syndrome and thus the application had a sound theoretical and practical basis, since the increased viscosity of the plasma could be directly related to peripheral manifestations of disease. The patients with abnormal lymphocyte response, responded clinically with better than 40% decrease of articular index, whereas none of four patients with normal lymphocyte response showed clinical improvement. Use of plasma exchange is based on the notion that a toxin, perhaps the monoclonal protein, an antibody or another plasma component directly injures the peripheral nerve or its sheath. The results from all of controlled trials, which are eagerly awaited, will help to determine the future role of plasma exchange as a form of therapy. As more evidence becomes available showing relative benefit or lack of benefit of PE, the current level of activity is rapidly changing.
