Plasmapheresis in rheumatologic emergencies

When should we use plasmapheresis in rheumatologic emergencies?

Bhaskar Dasgupta, MD: We need to use plasmapheresis/plasma exchange, particularly in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, so in patients with renal involvement, patients with alveolar hemorrhage, where there is capillaritis involving the lung and they are having an alveolar hemorrhage, or people who have pulmonary-renal involvement. These patients have a clear-cut indication for plasmapheresis/plasma exchange.

Similarly, in patients with lupus as well, when there is pulmonary-renal involvement due to lupus, we should use plasma exchange. In catastrophic antiphospholipid syndrome we use plasma exchange. There are all these situations where we should be using plasma exchange.