Aphereseverfahren bei Autoimmunerkrankungen

Sebastian Heibel; Kirsten de Groot

doi:10.1055/a-0992-7598

Der Klinikarzt, Table of Contents

Der Klinikarzt 2019; 48(08/09): 360-369
DOI: 10.1055/a-0992-7598

Schwerpunkt

Aphereseverfahren bei Autoimmunerkrankungen

Einsatz in der Primär- und Eskalationstherapie

Sebastian Heibel

¹Medizinische Klinik III (Nephrologie, Dialyse, Hypertensiologie, Rheumatologie), Sana Klinikum Offenbach GmbH, KfH-Nierenzentrum Offenbach, Offenbach a. M.

,

Kirsten de Groot

¹Medizinische Klinik III (Nephrologie, Dialyse, Hypertensiologie, Rheumatologie), Sana Klinikum Offenbach GmbH, KfH-Nierenzentrum Offenbach, Offenbach a. M.

› Author Affiliations

Abstract

ZUSAMMENFASSUNG

Aphereseverfahren finden neben ihrem etablierten Einsatz in derTransplantations- und Transfusionsmedizin vor allem in der Therapie autoimmunologischer entzündlich-rheumatischer und neurologischer Erkrankungen zunehmende klinische Anwendung. Ihre grundsätzliche Funktionsweise liegt im Entzug pathophysiologisch wirksamer Blutbestandteile (v. a. IgG-Antikörper) und weiteren immunmodulatorischen Effekten. Mögliche Apheresemodalitäten sind die unselektive Plasmapherese mit nachfolgendem Ersatz des entzogenen Plasmas durch verschiedenartige Substituate sowie die selektivere Immunadsorption. Die Therapie ist logistisch aufwendig, jedoch für den Patienten nebenwirkungsarm.

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References

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