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Titolo:
Patients with thrombotic thrombocytopenic purpura commonly develop metabolic alkalosis during therapeutic plasma exchange
Autore:
Marques, MB; Huang, ST;
Indirizzi:
Univ Alabama, Dept Pathol, Birmingham, AL 35294 USA Univ Alabama Birmingham AL USA 35294 ept Pathol, Birmingham, AL 35294 USA
Titolo Testata:
JOURNAL OF CLINICAL APHERESIS
fascicolo: 3, volume: 16, anno: 2001,
pagine: 120 - 124
SICI:
0733-2459(2001)16:3<120:PWTTPC>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEMOLYTIC-UREMIC SYNDROME; FACTOR-CLEAVING PROTEASE; IMPROVED SURVIVAL; EXPERIENCE;
Keywords:
plasmapheresis; thrombotic thrombocytopenic purpura; myasthenia gravis; citrate; bicarbonate; potassium;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Marques, MB Univ Alabama, Birmingham Hosp, Transfus Med Serv, 619 S 19th St,West Pavil,P220C, Birmingham, AL 35233 USA Univ Alabama 619 S 19th St,West Pavil,P220C Birmingham AL USA 35233
Citazione:
M.B. Marques e S.T. Huang, "Patients with thrombotic thrombocytopenic purpura commonly develop metabolic alkalosis during therapeutic plasma exchange", J CLIN APH, 16(3), 2001, pp. 120-124

Abstract

Thrombotic thrombocytopenic purpura (TTP) and myasthenia gravis (MG) are category I indications for therapeutic plasma exchange (TPE). This study wasbased on the hypothesis that the development of metabolic alkalosis duringTPE is more common in TTP than in MG, based on our previous observations. In order to test it, we compared the levels of bicarbonate and potassium inboth groups of patients undergoing plasmapheresis. Fifteen patients with TTP (190 procedures) and ten MG patients seen concurrently were studied. While baseline bicarbonate levels were similar among all patients, the post-procedure bicarbonate levels in TTP patients were mostly elevated with a meanSD of 29.4 +/- 3.5 mEq/L, as opposed to decreased or unchanged in MG patients 26.3 +/- 3.1 mEq/L (mean +/- SD) (P = 1.4 x 10(-8)). Furthermore, alkalosis in the TTP group persisted throughout subsequent daily treatments. There was also a significant decrease between pre- and post-TPE potassium levels in TTP patients (P = 3 x 10(-21)) by paired Student's t test. Additionally, samples with levels <3.3 mEq/L were alkalotic 75% of the time. In the MG group, however, potassium was normal in 85% and 83% of the pre- and post-TPE samples, respectively. Consequently, the hypokalemia was significantly more marked in the TTP group (P = 0.0008). These data confirm that plasmapheresis commonly induces metabolic alkalosis in TTP patients, probably due to high citrate in fresh frozen plasma, the frequency of treatments, and perhaps decreased renal clearance due to disease involvement of the kidneys. (C) 2001 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/10/20 alle ore 11:03:16