Plasma exchange is widely used and is safe to treat neurological diseases such as myasthenia gravis (MG) and multiple sclerosis (MS), according to a new study published in the journal Therapeutic Apheresis and Dialysis.

The treatment is already widely used to treat many immune-based neurological diseases. The present study aimed to analyze the characteristics of plasma exchange in patients with such diseases treated at the Clinical Center of Montenegro.

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The researchers analyzed 43 patients who were treated with plasma exchange from January 2020 to April 2022. Of these, 20 had Guillain Barré syndrome, 9 had MS, 4 had MG, and the remaining 10 had other neurological conditions in which the mechanism of disease development was excessive or inadequate immune system function. 

A total of 246 plasma exchanges were performed during this period. The treatment led to a reduction of Hughes in 14 of the 20 patients with Guillain Barré syndrome. 

It also led to a decrease in the Expanded Disability Status Scale score of at least 0.5 points in almost all (8 out of 9) patients with MS.

Finally, it led to a reduction in the Modified Rankin’s scale score in all 4 patients with MG treated with plasma exchange.

A total of 14 adverse events were recorded during the 245 plasma exchange cycles corresponding to 5.69% of cycles. Only 1 patient had a severe adverse event, which was staphylococcal sepsis.

“Our results show that [plasma exchange] is a widely used therapeutic method in the treatment of numerous neurological diseases in our center and that it is safe and well-accepted by our staff,” the authors concluded.

Plasma exchange is a treatment that involves the extracorporeal removal, return, or exchange of blood plasma or components. It has been used to treat several antibody-mediated central nervous system disorders, such as MS, neuromyelitis optica spectrum disorders, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, MG, acute disseminated encephalomyelitis, and autoimmune encephalitis.


Roganovic M, Erakovic J, Radulovic L, et al. Plasma exchange in neurology patients—experience from [a] single center in Montenegro. Ther Apher Dial. Published online August 28, 2023. doi:10.1111/1744-9987.14062