Allergic asthma bronchiale: Plasmapheresis with Clinical Success

"Therapeutic Apheresis or adsorption methods would seem advisable in patients with severe therapy-resistant allergic asthma bronchiale, particularly in status asthmaticus when medical therapy is inadequate. One could also consider Therapeutic Apheresis in the chronic steroid dependent asthmatic to decrease steroid requirements when indicated," Dr. Rolf Bambauer and colleagues suggest in their textbook "Therapeutic Plasma Exchange and Selective Plasma Separation Methods".

Based on the assumption that plasmapheresis can interrupt the allergic process at several points in the pathophysiology, Gartmann et al. performed plasmapheresis with clinical success in the case of severe asthma bronchiale as early as 1978. Therapeutic Apheresis intervenes directly in the pathomechanism and interrupts this process. After plasma exchange of two liters with a plasma volume of approximately 2,5 liters, the concentration of IgG was reduced by 50 percent.

"In a 34-year-old patient with asthma bronchiale and very high IgE serum concentrations, an average of 63 percent IgE was eliminated. Together with the plasma , other pathogenic substances such as antigens and immune complexes are also removed in comparable amounts. Also the IgE serum concentrations had reached their original levels again within 48 hours, the clinical symptoms improved after two to three Therapeutic Plasma Exchange treatment sessions. In this patient the significant clinical improvement was characterized by freedom from symptoms for several months and the improvement in lung function was impressive. This was the longest disease free interval that she had ever enjoyed ..."

>> Rolf Bambauer, Reinhard Latza, Ralf Schiel: Therapeutic Plasma Exchange and Selective Plasma Separation Methods, 4th Edition 2013, Pabst, 580 pages, ISBN 978-3-89967-732-4

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