Potential Danger of Thrombosis after Plasma Exchange in the Treatment of Patients with Immune Disease

Abstract

Coagulation studies were serially performed before and after repeated plasma exchange in 7 patients with myasthenia gravis. The fall in platelets and coagulation factor activities after plasmapheresis using a replacement material devoid of clotting factors was not so low that bleeding episodes were to be feared and no hemorrhages were observed. Thrombotic phenomena were suspected in 2 patients. Antithrombin III fell to undetectable levels in some cases. This finding associated with elevated values of factor [F] VIII-related antigen, FVIII coagulant activity and von Willebrand factor suggested a potential danger of thrombosis in such treated patients.