کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5985326 | 1178774 | 2016 | 4 صفحه PDF | دانلود رایگان |
- A case with hyperlipidemia, hyperglobulinemia, and thrombocytosis is reported.
- He was successfully treated by DFPP using a centrifuge/membrane hybrid system.
- The system may be useful for patients with particular situations.
Asparaginase-associated concurrence of hyperlipidemia, hyperglobulinemia, and thrombocytosis is a rare complication requiring aggressive lipoprotein apheresis, but no one of currently available lipoprotein apheresis methods can simultaneously resolve the 3 abnormalities. Herein, we reported a construction of double-filtration plasmapheresis (DFPP) using a combination of centrifugal/membranous plasma separation techniques to successfully treat a patient with hyperlipidemia, hyperglobulinemia, and thrombocytosis. A male presented with severe hyperlipidemia, hyperglobulinemia, and thrombocytosis during asparaginase treatment for NK/T-cell lymphoblastic lymphoma and was scheduled to receive lipoprotein apheresis. To simultaneously remove lipoproteins, immunoglobulin, and deplete platelets from blood, a centrifuge/membrane hybrid DFPP was constructed as following steps: plasma and part of platelets were separated first from whole blood by centrifugal technique and then divided by a fraction plasma separator into 2 parts: platelets and plasma components with large size, which were discarded; and those containing albumin, which were returned to blood with a supplement of extrinsic albumin solution. DFPP lasted 240Â minutes uneventfully, processing 5450-mL plasma. The concentrations of plasma components before DFPP were as follows: triglycerides 38.22Â mmol/L, total cholesterols 22.98Â mmol/L, immunoglobulin A (IgA) 15.7Â g/L, IgG 12.7Â g/L, and IgM 14.3Â g/L; whereas after treatment were 5.69Â mmol/L, 2.38Â mmol/L, 2.5Â g/L, 7.7Â g/L, and 0.4Â g/L, respectively. The respective reduction ratio was 85.1%, 89.6%, 83.9%, 39.4%, and 96.9%. Platelet count decreased by 40.4% (from 612Â ÃÂ 109/L to 365Â ÃÂ 109/L). Centrifuge/membrane hybrid DFPP can simultaneously remove lipoproteins, immunoglobulin, and deplete platelets, with a success in treatment of asparaginase treatment-induced hyperlipidemia, hyperglobulinemia, and thrombocytosis, and may be useful for patients requiring DFPP but with particular situations.
Journal: Journal of Clinical Lipidology - Volume 10, Issue 3, MayâJune 2016, Pages 646-649