Abstract
We describe the safety and efficacy of long-term immunoadsorbent plasmapheresis (IAPP) with dextran sulfate-cellulosebead columnsin antiphospholipidsyndrome (APS). IAPP was administeredto a 38-year old male Japanese patient with APS with Budd-Chiari syndrome (BCS), who had presented with refractory lower leg skin ulcers and arterial and venous thromboses including BCS. After hepatic vein transluminal angioplasty was performed, the combination of corticosteroid, aspirin and IAPP was administeredbecause of an underlyingbleedingtendencyrelated to liver dysfunction.From February 1994 to February 2003, a total of 228 procedureswere performed. No further thrombosis-relatedsymptoms or bleeding have occurred for more than nine years, suggesting that IAPP with dextran sulfate-cellulose columns is safe and effective for APS in preventingadditional thrombotic events. This IAPP supplements anticoagulation, antiplatelet, corticosteroid and immunosuppressant therapies.
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