ROLE OF PLASMAPHERESIS IN PRIMARY BILIARY-CIRRHOSIS

Five patients with primary biliary cirrhosis and prolonged cholestasis underwent intensive plasmapheresis. The indication for plasmapheresis included intractable pruritus or hypercholesterolemia and xanthomatous neuropathy. Patients noted a rapid improvement of pruritus and fatigue which was sustained as long as plasmapheresis was continued. Cholesterol levels were lowered an average of 10.3 mmol/l and xanthomata were reduced in 3 of 4 patients. Two patients with painful neuropathy caused by xanthomata experienced relief of this symptom. The liver and spleen size were not affected by plasmapheresis, and activities of aminotransferases, alkaline phosphate and titers of mitochondrial antibody remained unchanged. Plasmapheresis has a role in the therapeutic management of patients with advanced primary biliary cirrhosis who are disabled by the complications of pruritus, xanthomatus neuropathy or hypercholesterolemia with xanthoma formation.