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Old 07-29-2011
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Question Mul. sclerosis

there is a conflicting issue in its ttt about rule of plasma pharesis...

Kaplan notes..... used in acute severe exacerbations not relieved by steroids
UW ................. used to decrease freq of exacerbations....

i seek medscape M.S topic...... i cannot find rule of plasmapharesis at all..??
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Originally Posted by cerebrum85 View Post
there is a conflicting issue in its ttt about rule of plasma pharesis...

Kaplan notes..... used in acute severe exacerbations not relieved by steroids
UW ................. used to decrease freq of exacerbations....

i seek medscape M.S topic...... i cannot find rule of plasmapharesis at all..??

In acute, sudden severe MS relapses that don’t respond to steroids
-->plasmapheresis

In exacerbation some places it says steroids ,interferon but i could not find plasmapheresis
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In acute, sudden severe MS relapses that don’t respond to steroids
-->plasmapheresis

In exacerbation some places it says steroids ,interferon but i could not find plasmapheresis

so as kaplan said......... not rely on UW data in this issue..!!!
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Originally Posted by cerebrum85 View Post
so as kaplan said......... not rely on UW data in this issue..!!!
Consider emergent plasmapheresis. One study suggested this treatment may be superior to intravenous [IV] steroids in patients with acute fulminant MS.The 2011 AAN plasmapheresis guideline update stated that plasmapheresis is possibly effective and may be considered in acute fulminant demyelinating CNS disease.--> ACCORDING TO WEBMD.

During symptomatic attacks, patients may be hospitalized. As of 2007, administration of high doses of iv steroids such as methylprednisolone is the routine therapy for acute relapses. This is administered over a period of three to five days, and has a well-established efficacy in promoting a better recovery from disability. ACCORDING TO WIKIPEDIA.



Most of the article are saying in acute attack use steroids and if no improvement then plasmapheresis. Steroid itself reduces the disability and fasten recovery.

I could not find any article saying plasmapheresis is considered for reducing exacerbation frequency.and i am confused with steroid is considered to reduce ,heal, recovery the attack episode so will it reduce the FREQUENCYof attack do. So for first line treatment steroids are good and what is option to choose in exam regarding selecting for reducing frequency.


@ cerebrum85:can u plz tell what uw says in justification in choosing plasmapheresis for reducing frequency or can u elaborate more the given explanation?
You can see another article in treatmentsclerosis.com saying plasmapheresis is restricted for special case scenario but i could not get which?
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Thumbs Up great effort....well done

Quote:
Originally Posted by confident View Post
Consider emergent plasmapheresis. One study suggested this treatment may be superior to intravenous [IV] steroids in patients with acute fulminant MS.The 2011 AAN plasmapheresis guideline update stated that plasmapheresis is possibly effective and may be considered in acute fulminant demyelinating CNS disease.--> ACCORDING TO WEBMD.

During symptomatic attacks, patients may be hospitalized. As of 2007, administration of high doses of iv steroids such as methylprednisolone is the routine therapy for acute relapses. This is administered over a period of three to five days, and has a well-established efficacy in promoting a better recovery from disability. ACCORDING TO WIKIPEDIA.



Most of the article are saying in acute attack use steroids and if no improvement then plasmapheresis. Steroid itself reduces the disability and fasten recovery.

I could not find any article saying plasmapheresis is considered for reducing exacerbation frequency.and i am confused with steroid is considered to reduce ,heal, recovery the attack episode so will it reduce the FREQUENCYof attack do. So for first line treatment steroids are good and what is option to choose in exam regarding selecting for reducing frequency.


@ cerebrum85:can u plz tell what uw says in justification in choosing plasmapheresis for reducing frequency or can u elaborate more the given explanation?
You can see another article in treatmentsclerosis.com saying plasmapheresis is restricted for special case scenario but i could not get which?

i think what u get is sufficient 2 get the dust away of the issue
that is ....1st line tt of M.S acute exacerbatn is Pulse steroid ttt(high dose methylprednis. 3-5 days followed by tapering over 4 weeks)
in exacerbations not responding ........that what needs plasmapharesis.
.................................................. ..................................................
about UW ..... it mentioned ... that interventions to decrease frequency of attacks ... INF , glutiramer , cyclophsphamide, plasmapharesis , ....etc
in another choice ... plasmapheresis may enhance beneficial effects of immunosuppresion. ...........................(last updated 7.7.2010)

giving kaplan data +ur data +medscpe data .....i think it may be an old recommendation that had been renewed....!!may be
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