Marked Clinical Improvement in Parkinson’s Disease Following Double-Filtration Apheresis: A Case Report

Parkinson’s disease (PD) is the fastest growing progressive neurological disorder globally, characterized by motor symptoms such as bradykinesia, rigidity, resting tremor as well as a wide range of non-motor manifestations. Here, we report the case of a patient with advanced Parkinson’s disease diagnosed for PD more than 12 years ago; clinical symptoms included a coarse resting tremor with a focus on the right arm and leg, gait and postural disturbances, sleep disorders and autonomic disfunctions. The patient received several medications for correction of dopamine deficiency, but clinical symptoms progressed over the years. We applied a series of double-filtration apheresis treatments and experienced marked symptomatic improvement, with near-complete resolution of motor deficits and strong decrease of MDS-UPDRS part III score. This case suggests a potential role of extracorporeal blood purification in the management of PD. Plain Language Summary: Parkinson’s disease is a long-term brain disorder that gradually worsens over time. It affects movement, causing symptoms such as slowness, stiffness, and shaking, and can also lead to problems with sleep, sense of smell, balance, and automatic body functions. Current treatments mainly aim to replace dopamine, but do not stop disease progression. This report describes a patient who had Parkinson’s disease for more than 12 years whose condition continued to worsen despite standard therapy. The patient had severe tremor, impaired walking and posture, sleep disturbances, loss of smell and autonomic symptoms. A special blood-cleaning treatment called double-filtration apheresis was used. This treatment filters the blood to remove certain harmful substances of larger mass as, for example, immune complexes, autoantibodies or substances that trigger inflammation, before returning it to the body. After a series of treatments, the patient showed marked improvement, with most movement problems almost completely disappearing and restoration of sense of smell and sleep. The improvement of symptoms was also reflected in improved laboratory results. This is a single case, so firm conclusions cannot be drawn and further clinical studies are needed. Overall, therapeutic apheresis may represent a promising additional treatment option for patients with advanced Parkinson’s disease who do not respond well to standard therapies.