Information for the patient
Since several years the immunoadsorption has been successfully applied for different immunological illnesses.
It was always chosen when the patient could not be helped with medicines
Immunoadsorption is not comparable with plasmapheresis, because immunoadsorption only removes the immunoglobulins from the blood.
Immunoadsorption has been previously applied in clinical treatment with these indications
- Myasthenia Gravis
- Multiple Sclerosis
- Muscle Wasting*
- Goodpasture Syndrome
- Focal Sclerosing Glomerulonephritis
- Systemic Lupus Erythematodes SLE
- Sjögren Syndrome
- Mixed Collagenosis
- Rheumatoid Arthritis
- Primary Biliary Cirrhosis
- Gluten Sensitive Enteropathy GSE
- Celiac Disease
- Inflammatory Bowel Diseases*
- Ulcerative Colitis*
- Crohns Disease*
- Malignant Exophthalmus
- Diabetes Mellitus IDDM
- Pemphigus Vulgaris / Foliaceus
- ITP ( Immunogene Thrombocytopenic Purpura )
-TTP ( Thrombotic Thrombocytopenic Purpura )
- Hemophilia A and B
- Pernicious Anemia
- Dilative Cardiomyopathy DCM
* is being discussed. Single case reports
The goal of the immunoadsorption is to remove certain injurious antibodies from
the blood circulation of the patient, and to stop by this means the existing immunological illness.
The illness you suffer from is also an autoimmune desease. Unfortunately the causes of this illness could not be clarified in detail until now.
It is however known, that certain antibodies are formed in the organism, and that these substances are directed against the tissue of the body itself.
With some diseases successes in the treatment with immunoadsorption have been already achieved, although the special antibody could not be isolated yet. It is
therefore suggested, that the treatment with immunoadsorption can changean imbalance in the overall immunosystem back to a balance. Thereby it is possible with some autoimmune illnesses, to maintain this positive change for a very long time, maybe even durably. In most cases, however, a change has to be assumed for a certain time.
Obviously, with you it has been repeatedly tried to bring the illness to a stop or healing with thehelp of special medicines (immunosuppressiva, e. g. Prednisolon, Zyclophosphamid ). Unfortunately this goal could not be achieved sufficiently. Therefore I would like to propose, after discussion and in cooperation with your treating doctor, to employ the IgG-immunoadsorption for the removal the pathogenic antibodies. As with medicines, a guarantee for the success of this new treatment cannot be given. There is, however, a solid possibility, that immunoadsorption can help you to fight against your illness.
The extracorporal immunoadsorption is an apparative method which resembles the treatment with the kidney machine. With the immunoadsorption the antibodies are washed out of the blood. A treatmentlasts about four hours. It is ambulatory. Inpatients can be treated in Klink Gut Wienebüttel. A particular entrance to the blood-vessel system as with the dialysis is only very rarely necessary.
The following treatment scheme has proven to be rational: during the first two weeks there are three weekly treatments. In the third and fourth week two treatments per week will follow . Before and after each treatment blood samples are taken.
With these the antibody titers are determined. The amount of and the periods between the treatments from the fifth week on conform to the amount of the antibody titer. Probably only two more treatments will be necessary in a period of four weeks from that point of time on.
Before beginning the immunoadsorption you will be examined by a specialist whois independent of the doctors which perform the immunoadsorption. This specialist can be one of your previous doctors, if he/she meets a corresponding specialized requirement for the field of your illness.
After periods of four weeks and half a year after the beginning of the immunoadsorption you will be examined again by the independent doctor. These investigations are necessary, to be able to estimate the efficacy the immunoadsorption treatment objectively. These investigations are also a legitimate demand of the health insurance company which is to ensure the cost acceptance at the same time.
The final examination after half a year will give information , whether the treatment of you has been successful and whether a continuation of the treatment appears to be necessary and expediently. But it is still possible, that a treatment success will occur earlier and the time of treatment can be shortened thereby.
Which side-effects of the treatment are to be considered?
During the treatment, as with every detoxification of the blood, a blood pressure drop may occur which will be treated by the physician immediately in order to stabilize the pressure.It is possible basically, that an incompatibility against the adsorbing
material or the tubing systems evolves, which may cause an allergic reaction up to an anaphylactic shock. Such a heavy reaction, however, has not been observed during the last six years with the immunoadsorption columns of the Therasorb company. After such a reaction a discontinuation of the treatment must be decided.
Which medicines do I take during the treatment?
In principle you can continue taking all medicine having been so far prescribed in unchanged dosage. No interferences between the medicines which you take and the immunoadsorption are known until now. If you wish to take additional medicaments, please arrange this with your family doctor or with the specialists who perform the immunoadsorption.
There are some changes with regard to medicine especially prescribed against autoimmune diseases. During theperiod of immunoadsorption treatment administration of Prednisolon should not exceed a dosage of 10 mg per day.
As a basal therapeutic against the autoimmune sickness you will receive the immunosuppressivum Cyclophosphamid. This or a comparable medicine you certainly know already. For Cyclophosphamid is known, that it inhibits the new formation of antibodies more effectively than comparable medicines, after they have been removed by immunoadsorption. The dosage will be adjusted to your body.
Since you take already immunosuppressive medicines, their possible side-effect have already been explained to you. Here a short summary again.
1. Due to the medicine you are more susceptible for infections. Thus protect yourself from hypothermia and avoid the contact with persons, who have a flu or cold or another contagious illness.
2. There may eventually occur changes in the blood count . Therefore, every four weeks a check of the blood count will be performed, possibly even more frequently.
3. As an undesirable side-effect you might loose your hair. The dosage in which you receive this medicine is however determined in a way, that only a minor hair loss will occur from time to time.
4. In the first weeks, in which you receive this medicine, it can occur that flu-like symptoms appear as muscle- and arthritic pains. In the further course of the therapy , however, a habituation of the organism at the medicine starts, so that these side-effects become slight or disappear. Through the treatment with the immunoadsorption the pathogenic antibodies are predominantly removed. It is inevitable, that simultaneously also a part " useful ", e. g. antibodies necessary for the immunodefence are lost. If necessary, you will receive an infusion with " useful " antibodies which are necessary for your immunodefense following the treatment.
Which medicines against pains can I take?
Surely, until now you have taken Paracetamol-pills, -suppositories or Indometacin as analgesics. These medicines have beside theiranalgesic also an inflammation inhibiting effect. This effect can superpose the positive effect of the treatment by means of immunoadsorption. Therefore we ask you to arrange the receipts of pain medicaments with your family doctor and with the specialist performing the immunoadsorption in advance.
Whom can I contact for questions and problems?
Your current family doctor remains your treating doctor further on whom you can contact at any time. Treatment of inpatients in Klinik Gut Wienebüttel
For special questions which relate to the treatment by means of immunoadsorption you can contact me at any time under the following address:
Specialist in internal medicine
Am Berge 21-24
Fax : 0-4131-7364-44
E-mail : Panos@tsolkas.de
TREATMENT BY IMMUNOADSORPTION
Cardiomyopathy DCM -