2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T853,Multisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory condition with multi-organ involvement, particularly affecting the cardiac and gastrointestinal systems. Although immunomodulatory therapy is standard, treatment approaches vary. This study aimed to evaluate treatment modalities in MIS-C such as methylprednisolone (MP), intravenous immunoglobulin (IVIG), anakinra and therapeutic plasma exchange (TPE) based on clinical severity and laboratory parameters in a prospectively followed cohort. A total of 125 MIS-C patients were included in the study and followed for at least 6 months after discharge. Patients were stratified by severity and treated with various immunomodulatory regimens, including IVIG+MP, IVIG+MP+anakinra, and IVIG+MP+anakinra+TPE. Patients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20-24 mg/dL, ferritin 308-846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper. The mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration. Demonstrates that short-term, biomarker-guided use of anakinra and corticosteroids effectively controls hyperinflammation in MIS-C. Highlights that prolonged corticosteroid therapy may not be necessary, even in severe cases. Provides evidence of early cardiac recovery, including resolution of CAAs, without post-discharge steroids. Supports a steroid-sparing treatment approach, reducing risks of long-term immunosuppression. May inform future MIS-C treatment guidelines by minimizing the need for escalation therapy, ECMO, and related complications.31:Te4b,Abstract Background Multisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory condition with multi-organ involvement, particularly affecting the cardiac and gastrointestinal systems. Although immunomodulatory therapy is standard, treatment approaches vary. This study aimed to evaluate treatment modalities in MIS-C such as methylprednisolone (MP), intravenous immunoglobulin (IVIG), anakinra and therapeutic plasma exchange (TPE) based on clinical severity and laboratory parameters in a prospectively followed cohort. Methods A total of 125 MIS-C patients were included in the study and followed for at least 6 months after discharge. Patients were stratified by severity and treated with various immunomodulatory regimens, including IVIG+MP, IVIG+MP+anakinra, and IVIG+MP+anakinra+TPE. Results Patients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20–24 mg/dL, ferritin 308–846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper. Conclusion The mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration. Impact

Demonstrates that short-term, biomarker-guided use of anakinra and corticosteroids effectively controls hyperinflammation in MIS-C.

Highlights that prolonged corticosteroid therapy may not be necessary, even in severe cases.

Provides evidence of early cardiac recovery, including resolution of CAAs, without post-discharge steroids.

Supports a steroid-sparing treatment approach, reducing risks of long-term immunosuppression.

May inform future MIS-C treatment guidelines by minimizing the need for escalation therapy, ECMO, and related complications.

25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Therapeutic Plasma Exchange: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Therapeutic Plasma Exchange (modality). Clinician-written summaries and actionable practice insights. 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Clinicians should interpret recovery rates cautiously given the very wide CIs (e.g., excellent recovery 33%–100%).","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218300","tag_type":"warning","value":"PROSPERO registration number appears to contain a formatting inconsistency (CRD420251169201) as transcribed from the abstract — verify against the registry if citing.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218300","tag_type":"warning","value":"The mean age (35 ± 17 years) spans a broad range potentially including adolescents; age group tagged as 'adult' based on the reported mean, but the study population may include pediatric patients.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis evaluated the effectiveness and safety of plasmapheresis (versus IVMP or IVIG) for acute MOGAD attacks across 10 studies (1,045 patients, 1,368 attacks; mean age 35 ± 17 years, 56.5% female), with data from 8 studies pooled for analysis.","key_result":"In optic neuritis, plasmapheresis improved visual acuity (logMAR mean difference 1.43; 95% CI 0.63–2.24) with an excellent recovery rate of 81% (95% CI 33%–100%). For myelitis/cerebral involvement, good recovery reached 94% (95% CI 88%–100%). Adverse events were rare at 3% (95% CI 1%–14%).","limitations":"High heterogeneity across studies due to variable design, treatment timing, and attack severity. No randomized controlled trials were included. Wide confidence intervals (e.g., excellent recovery 33%–100%) limit precision of estimates.","practice_takeaway":"Plasmapheresis appears to be a safe escalation option for steroid-refractory MOGAD attacks, especially isolated optic neuritis. Clinicians should be aware that evidence remains observational and randomized trials are still needed before firm protocols can be established."}},{"doi":"10.1016/j.transci.2026.104481","pmid":"42385586","title":"Therapeutic plasma exchange in Alzheimer’s disease: From clinical trial to real-world evidence","journal_title":"Transfusion and Apheresis Science","journal_issn":"1473-0502","published_at":"2026-06-28T00:00:00.000Z","url":"https://doi.org/10.1016/j.transci.2026.104481","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:33.915Z","updated_at":"2026-07-05T13:38:33.915Z","tags":[{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"modality","value":"Anti-Amyloid Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"modality","value":"Therapeutic Plasma Exchange","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"warning","value":"No sample size is reported as this is a review article, not a primary study; the AMBAR trial and real-world cohort data are discussed but not re-analyzed.","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"warning","value":"Study design classification as 'Narrative Review' is inferred from the abstract; the article does not explicitly label itself as such.","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104481","tag_type":"warning","value":"This is a narrative review that includes the author's personal clinical experience, which may introduce selection or advocacy bias — interpret practice-level claims with caution.","value_numeric":null}],"summaries":{"what_studied":"This review examines therapeutic plasma exchange (TPE) as a disease-modifying strategy in Alzheimer's disease (AD), covering the AMBAR trial, earlier pilot studies, real-world cohort evidence, and mechanistic comparisons with anti-amyloid monoclonal antibodies.","key_result":"TPE is presented as a broadly acting, biologically rational therapy that contrasts with selective anti-amyloid monoclonal antibodies by targeting multiple AD pathways — including immune dysregulation, oxidative stress, vascular injury, impaired protein clearance, and synaptic dysfunction — with supporting evidence from the AMBAR trial and real-world cohort data.","limitations":"This is a narrative review incorporating the author's personal clinical experience, which introduces potential bias. No new primary trial data or head-to-head comparative efficacy figures are reported. Real-world cohort evidence is discussed but not systematically synthesized.","practice_takeaway":"TPE may offer a multi-mechanistic approach to AD that complements or contrasts with anti-amyloid antibody therapies; clinicians managing AD patients should be aware of the evolving real-world evidence base for TPE as an outpatient, chronic disease-management strategy."}},{"doi":"10.1016/j.transci.2026.104482","pmid":"42391726","title":"Therapeutic plasma exchange and immunomodulatory strategies in post-infectious syndromes: A review of immune dysregulation in PTLDS, long COVID, ME/CFS, and PANS/PANDAS","journal_title":"Transfusion and Apheresis Science","journal_issn":"1473-0502","published_at":"2026-06-26T00:00:00.000Z","url":"https://doi.org/10.1016/j.transci.2026.104482","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:34.195Z","updated_at":"2026-07-05T13:38:34.195Z","tags":[{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"condition","value":"Long COVID","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"condition","value":"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"condition","value":"PANS/PANDAS","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"condition","value":"Post-Treatment Lyme Disease Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"modality","value":"Intravenous Immunoglobulin","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"modality","value":"Therapeutic Plasma Exchange","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"warning","value":"No primary data were collected; all conclusions are based on synthesis of existing literature, limiting evidentiary strength.","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"warning","value":"PANS/PANDAS primarily affects pediatric patients while the other syndromes predominantly affect adults; pooled analysis across these age groups may obscure age-specific treatment signals.","value_numeric":null},{"paper_doi":"10.1016/j.transci.2026.104482","tag_type":"warning","value":"The paper is dated June 2026, which is very recent; some cited trial results (e.g., phase II TPE in post-COVID) may not yet be widely peer-reviewed or replicated.","value_numeric":null}],"summaries":{"what_studied":"This narrative review evaluated immune dysregulation across four post-infectious syndromes—PTLDS, long COVID, ME/CFS, and PANS/PANDAS—and assessed the rationale and evidence for immunomodulatory therapies including IVIG, rituximab, and therapeutic plasma exchange (TPE).","key_result":"Evidence for immune-targeted treatments is strongest in patients with identifiable immunologic abnormalities. The phase III RituxME trial (rituximab in ME/CFS) and a phase II TPE trial in post-COVID both failed to show efficacy in unselected populations, highlighting the need for biomarker-guided patient selection.","limitations":"Narrative review design limits causal inference; evidence synthesis across heterogeneous syndromes may obscure condition-specific signals; lack of controlled trials with immunologic phenotyping leaves treatment recommendations largely observational.","practice_takeaway":"Avoid broad use of TPE or rituximab in unselected post-infectious syndrome patients—reserve immune-directed therapies for those with demonstrable autoantibody burden or defined immunologic phenotypes. Controlled trials with biomarker-based stratification are urgently needed."}},{"doi":"10.1002/jca.70135","pmid":"42169439","title":"Can Plasma Exchange Be Used to Lower the Circulating Burden of Microplastics in Human Patients?","journal_title":"Journal of Clinical Apheresis","journal_issn":"0733-2459","published_at":"2026-05-21T00:00:00.000Z","url":"https://doi.org/10.1002/jca.70135","source_score":38,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-31T13:35:30.957Z","updated_at":"2026-05-31T13:35:30.957Z","tags":[{"paper_doi":"10.1002/jca.70135","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"brand","value":"Spectra Optia","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"condition","value":"Microplastic Burden","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"modality","value":"Therapeutic Plasma Exchange","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"sample_size","value":"n=114","value_numeric":114},{"paper_doi":"10.1002/jca.70135","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"study_design","value":"Prospective Observational Study","value_numeric":null},{"paper_doi":"10.1002/jca.70135","tag_type":"warning","value":"Study design is labeled 'Prospective Observational' based on context; the paper does not explicitly state the design type. No comparator or control group is described, which limits causal inference. The patient population's underlying conditions requiring TPE are not specified, which may affect generalizability. 'Circulating MP reduction' is a surrogate outcome — no clinical endpoints are reported.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether therapeutic plasma exchange (TPE) using the Spectra Optia Apheresis System could reduce circulating microplastic (MP) levels in blood, measuring MP before and after 174 one-plasma-volume TPE procedures in 114 patients.","key_result":"TPE significantly reduced circulating microplastics in human patients; however, at low baseline MP levels, the reduction was partially offset by leaching of MPs from the plastic apheresis tubing set back into the circulation.","limitations":"MP leaching from the plastic apheresis tubing confounds results at low baseline levels; no long-term follow-up on clinical outcomes; no control group or sham procedure comparator.","practice_takeaway":"TPE can reduce circulating microplastics, but the clinical benefit remains unclear given recontamination from tubing. Clinicians should be aware that apheresis equipment itself is a source of MP exposure during the procedure."}},{"doi":"10.1097/hep.0000000000001787","pmid":"42102094","title":"Buying time: Therapeutic plasma exchange as a bridge to transplant in acute-on-chronic liver failure","journal_title":"Hepatology","journal_issn":"0270-9139","published_at":"2026-05-08T00:00:00.000Z","url":"https://doi.org/10.1097/hep.0000000000001787","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:14.947Z","updated_at":"2026-05-15T13:23:14.947Z","tags":[{"paper_doi":"10.1097/hep.0000000000001787","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001787","tag_type":"condition","value":"Acute-on-Chronic Liver Failure","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001787","tag_type":"generic","value":"plasma exchange","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001787","tag_type":"modality","value":"Therapeutic Plasma Exchange","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001787","tag_type":"warning","value":"Only the paper title, DOI, journal, and publication date were provided — no abstract, methods, results, or discussion text was supplied. All structured summary fields requiring specific data (key result, limitations, practice takeaway, sample size, study design, level of evidence, sex, age group) cannot be populated without speculating. Only condition and modality tags can be reliably inferred from the title alone.","value_numeric":null}],"summaries":{"what_studied":"The study evaluated therapeutic plasma exchange (TPE) as a bridge-to-transplant strategy in patients with acute-on-chronic liver failure (ACLF), examining its potential to stabilize or improve organ function while awaiting liver transplantation."}},{"doi":"10.1038/s41390-025-04706-6","pmid":"41519951","title":"Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome","journal_title":"Pediatric Research","journal_issn":"0031-3998","published_at":"2026-01-11T00:00:00.000Z","url":"https://doi.org/10.1038/s41390-025-04706-6","source_score":21,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-12","doi":"10.1038/s41390-025-04706-6","days":"7","issn":"0031-3998","rank":"6","field":"Clinical Medicine","score":"21","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1038/s41390-025-04706-6","title":"Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome.","journal":"Pediatric research","methods":"","results":"Patients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20-24 mg/dL, ferritin 308-846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper.","abstract":"$30","keywords":[],"pubmed_id":"41519951","conclusions":"The mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration.","publication_date":"2026-01-11T00:00:00"},"crossref":{"DOI":"10.1038/s41390-025-04706-6","URL":"https://doi.org/10.1038/s41390-025-04706-6","ISSN":["0031-3998","1530-0447"],"link":[{"URL":"https://www.nature.com/articles/s41390-025-04706-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41390-025-04706-6","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41390-025-04706-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome"],"author":[{"given":"Osman Oguz","family":"Demir","sequence":"first","affiliation":[]},{"given":"Kubra","family":"Aykac","sequence":"additional","affiliation":[]},{"given":"Arthur Hoi Hin","family":"Cheng","sequence":"additional","affiliation":[]},{"given":"Selman","family":"Kesici","sequence":"additional","affiliation":[]},{"given":"H. 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Treatment intensity was guided by CRP and ferritin (mild: CRP 9 mg/dL, ferritin 192 µg/dL; higher inflammation without cardio-pulmonary support: CRP 20–24 mg/dL, ferritin 308–846 µg/dL; shock/MAS/bicytopenia or cardio-pulmonary support prompted escalation including high-dose MP, anakinra, and TPE).","limitations":"Severity-guided treatment allocation in this prospective cohort limits causal inference between regimens. The abstract provides few outcome metrics (e.g., no event rates for cardiac recovery, ICU/ECMO use, or adverse events).","practice_takeaway":"When treating MIS-C, use CRP, ferritin, and clinical severity to tailor short-course IVIG+MP±anakinra, reserving TPE for cardio-pulmonary support. 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