Plasmapheresis in systemic lupus erythematosus. a cautionary note

Plasmapheresis was used as the sole treatment modality in 4 patients with systemic lupus erythematosus. The presence of circulating immune complexes in this group of patients was not predictive of response to plasmapheresis. Lymphocytotoxic antibody levels fell in 3 of the 4 patients, and no consistent changes in T lymphocytes, T lymphocyte subsets, complement, or immunoglobulin levels were observed. Followup during the subsequent 6 months showed deterioration in clinical and laboratory parameters in all 4 patients, and the protocol was discontinued. Plasmapheresis without concomitant therapy may be detrimental to certain patients with systemic lupus erythematosus.