Would plasmapheresis be an option? - Hughes Syndrome A...

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Would plasmapheresis be an option?

Wittycjt profile image
27 Replies

KellyInTexas there is an article “ plasmapheresis for the Antiphospholipid patient.” Google this I nformation. Maybe clear out the Antiphospholipids reeking havoc to get things under control and start over? With maybe new less effective Antiphospholipids if this is even possible since yours seem so aggressive.

Anyone, any thoughts trying to help someone here.

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Wittycjt profile image
Wittycjt
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27 Replies
Wittycjt profile image
Wittycjt

I know it wouldn’t be a cure but would clean out yours, specifically because yours are so aggressive and when/if they return maybe they would return less aggressive, I’m just thinking...Cindy I could be totally off base here

HollyHeski profile image
HollyHeskiAdministrator

Hi, really thoughtful of you - Ive posted the paper for all to see, Im afraid the science of this goes above my head, but nice to see a fresh individual patient approach.

ncbi.nlm.nih.gov/pmc/articl...

Wittycjt profile image
Wittycjt in reply to HollyHeski

Thank you for posting the link Holly,have a great day, Cindy

Wittycjt profile image
Wittycjt in reply to Wittycjt

I hope she reads it, may be an option for what she is going through

KellyInTexas profile image
KellyInTexasAdministrator

Just read it- sent it to my email. Thanks ladies.

I don’t know if I’m “ that sick.”

My vitals are stable... I’m just clotting wde spread to all 4 limbs with confirmed DVT in one arm. Definitely superficial clotting to both legs. Now I think some clotting in good arm- but just is happening- so have not been scanned. Hard to tell if it’s superficial or deep.

I think liver is getting tiny little micro clots likely not detectable by any scans. ( I lost my gall bladder to this APS years ago so my liver has to take over storing bile- and it’s quire obvious when it suddenly gets stressed and can’t hold bile... it dumps it like a liquid fluorescent yellow highlighter. Very caustic and it makes me very sick. So this is happening. So my liver is being stressed now- and it’s tender. So I think little clots are bothering it. I have not had this happen since I had the gall bladder surgury almost 20 years ago and the liver was being “ trained” to store bile...

Other than that organs are ok right now. So I don’t think I would meet the criteria for it but I’m going to ask Monday. Absolutely. They are very adamant here about risk/ benefit . And I think this is a good thing... but knowing that balance is difficult .

Thanks again to both of you! ❤️

lupus-support1 profile image
lupus-support1Administrator in reply to KellyInTexas

The plasma exchange is performed as an out-patient over the course of a few weeks. Unfortunately, the effects only last a few months.

In terms of this one case study:

"However, this is a case report and definite conclusions can not be drawn concerning the effectiveness of plasmapheresis and rituximab for the long term control of the APS. Moreover, we were not able to monitor B cell count following rituximab administration to assess the effectiveness of the dosing regimen on target cells (B cells)."

Wittycjt profile image
Wittycjt in reply to lupus-support1

Well, it would be nice if Kelly could get some relief right now, maybe have “onslaught” relax and deal with the aftermath later. I would hope it cannot get much worse for her. She hasn’t caught “any” breaks just one thing after another, Cindy

ndstephens49 profile image
ndstephens49 in reply to lupus-support1

I have taken Rituxan many times. I have tolerated it very well. I first took it for nonhodgkins lymphoma in 2001.

From 2007-2012 I took it many more times (can’t remember how many—at least 10) mainly for vasculitis. During this time period my blood oxygen was also very low and I was on supplemental oxygen 24/7.

No one could figure out why I needed oxygen. My bronchoscopy revealed some COPD but not enough to account for the low oxygen saturation in my blood.

In August of 2008 I was able to discontinue the use of oxygen during the day. Again, no one was sure why but most doctors felt the Rituxan benefitted both the vasculitis (my skin cleared up) and my lungs,possibly because clotting may have also been involved.

Nancy in West Virginia

lupus-support1 profile image
lupus-support1Administrator in reply to ndstephens49

Wishing you better health and good wishes,

Ros

Wittycjt profile image
Wittycjt

Great glad you will ask about it on Mon. Would be good to get ahead of it if possible. It seems it may help you, Cindy

GinaD profile image
GinaD

A doctor, years ago, offered pasmophoresis to treat my APLS. I responded with an observation that the root cause of my disease was a “computer error” in one of the organs that produce the confused antibodies, and that therfore, this procedure would be temporary. And knowing when those “golden days” were passed and when to restart the warfarin BEFORE I got another DVT or mini stroke did not really appeal to me. I told him if he could produce a paper documenting the long term (which I defined as 1 year) benefits to let me know and I’d reconsider. He smiled and nodded and agreed with my concerns and never made that offer again.

But this may indeed be helpful for those in the midst of an uncontrollable flair — said the English major housewife from West Virginia who really does not have any medical credentials.

ndstephens49 profile image
ndstephens49 in reply to GinaD

I think plasmapheresis is used in acute/critical situations where short term treatments are used to provide some relief to help the body survive a critical situation.

Nancy

Wittycjt profile image
Wittycjt in reply to ndstephens49

That’s my thought too Nancy

KellyInTexas profile image
KellyInTexasAdministrator in reply to ndstephens49

That’s my understanding- let’s find out.

KellyInTexas profile image
KellyInTexasAdministrator

Gina, tell me, ( because right now my memory is not super spot on) are you referring to the bone marrow as the “ organ” that produces the APLS antibodies?

GinaD profile image
GinaD

As far as my limited knowledge is concerned, there are a number of steps in the autoimmunity chain. Bone marrow, thymus, lymph nodes, bone marrow— its not a centralized system. But I believe the master copies of autoimmune targets are stored in the thymus.

KellyInTexas profile image
KellyInTexasAdministrator in reply to GinaD

Interesting! I did not know that.

Lure2 profile image
Lure2 in reply to KellyInTexas

Hi Kelly,

Glad to hear from you!

I am thinking of you every day now and wonder how you are getting along.

Kerstin

KellyInTexas profile image
KellyInTexasAdministrator in reply to Lure2

I am feeling pretty bad! Yesterday was horrible migraine. My knee ( left leg is what I posted photo of) is bruising in front now. Right leg is now bruising on outer calf. The veins will feel like a tight band has been placed on them- cutting off circulation- then veins will sting and throb- then the next day the bruises will appear. Often it will feel like an “ invisible nurse “ has suddenly started an IV in a vein in the affected area. Good arm I think is now clotting for sure. Could be superficial. My doctors don’t get excited now. They just “know I clot...”

I have two internists. ( GP with advanced training in internal organs and vascular system.) one in my small local town and one in San Antonio, an hour south east of where I live. They are both very worried. I saw them both. The local one ordered scan- he wanted me on a plane back to London Bridge this week. He thinks shutting down immune system is only option but wants London Bridge to agree. I told him in the past Prof Hughes has been reluctant as its not been proven and I’m not up to travel. I also told him neurology in London was advancing and some neuro patients were being carefully screened for modulation. Not as extreme as cytoxan- but I’m repeat clotting every 8-10 weeks , strong neuro component- ( seizures in the lobes he’s working with- multi organ involvement- etc...

The other internist- dr Seleh Jaffar, was a teaching doctor at the university hospital in San Antonio. He has a urgent work in for me Monday morning with new hematologist in San Antonio. He said he’s not as stron in hematology as the one I have you with- but something’s not working so I understand. We are setting it up as a consult only.

Dr Jaffar said has also never had an APS patient. He said he is at a complete loss and does not understand what is happening to me.

I feel very sick. Better in mornings. Worse by evenings. I am staying in bed. I have not left home since 4 days? My stomach is not working well- I’m running fevers. ( not high.) When I go to sleep at night I wake up- look at clock, think it’s morning, but only one hour has passed... and I think to myself... “ oh my God. I still have this entire night to get through...

Actually last night I managed two and 1/2 hours at a time... with 30 min between.

It’s just not letting me rest.

I have to think it’s a “ flare” of some kind and when I flare, for me, for my body, I clot. It’s just what I think.

Wittycjt profile image
Wittycjt

Tomorrow will soon be here. Best of luck with your appointment. Let us know what happens many including me are concerned about you. Good luck😊Cindy

KellyInTexas profile image
KellyInTexasAdministrator

Starting to feel a little better! Thank goodness- holy cow! Actually got out of bed -went to the grocery store- and caught up on laundry today! That was crazy!

Wittycjt profile image
Wittycjt

Excited to see how tomorrow turns out , Good luck, Cindy

Wittycjt profile image
Wittycjt

So excited to,hear of your visit....what happened?Cindy

KellyInTexas profile image
KellyInTexasAdministrator in reply to Wittycjt

Waiting for some blood tests and this new heme is calling London Bridge immediately . ( I don’t think that’s going to be helpful with regards to questions about immune suppression.) He’s also calling my APS specialty heme. He’s arming himself with more info .

He’s wasting no time getting a more comprehensive picture.

I’m waiting to post until I have more answers so I don’t start lots of loose end questions without answers . It’s all still way up in the air and very radical right now. It gets confusing for everyone, pointlessly. and tough on my eyes!

Wittycjt profile image
Wittycjt in reply to KellyInTexas

Oh well!

KellyInTexas profile image
KellyInTexasAdministrator

No joke.

Wittycjt profile image
Wittycjt

Oops, I was talking about the plasmapheresis. I guess we will never know.

Certainly not about your eyes that’s awful

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