Exploring therapeutic plasma exchange as a progressive treatment modality for neurological disorders: Insights from a tertiary care hospital in Northwestern India over 3 years

BACKGROUND: Neurological disorders with autoimmune or inflammatory etiology pose significant challenges in terms of treatment. Therapeutic plasma exchange (TPE) has emerged as a promising adjunctive therapy for managing these conditions by removing pathogenic autoantibodies, immune complexes, and proinflammatory mediators. However, the experience with TPE in neurological disorders in the northwestern part of India is limited. METHODOLOGY: This retrospective study analyzed the medical records of patients who underwent TPE for neurological disorders over a 3-year period at a tertiary care hospital. Patient demographics, clinical diagnoses, TPE protocols, and adverse events were collected and analyzed. Descriptive statistics were used to summarize the data. RESULTS: A total of 26 patients (14 males, 11 females) underwent 111 TPE procedures during the study period. The most common clinical diagnoses were generalized dystonia, Guillain–Barré syndrome, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. TPE protocols involved exchanging one plasma volume every alternate day, with replacement solutions including fresh-frozen plasma (FFP), albumin, or a combination of FFP and albumin. The majority of patients showed positive clinical improvement measures, indicating the efficacy of TPE in halting disease progression and ameliorating symptoms. Adverse events were reported in seven procedures but were successfully managed. CONCLUSION: This study demonstrates the effectiveness and safety of TPE in the management of autoimmune or inflammatory neurological disorders in the northwestern part of India. TPE showed positive clinical improvement measures and a favorable safety profile. These findings contribute to the growing recognition of TPE as an emerging therapeutic modality in the field of neurology. Further research and prospective studies are needed to optimize TPE’s use, including patient selection, treatment protocols, and long-term outcomes in this population.