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Plasmapheresis In The Initial Treatment Of Insulin-Dependent Diabetes Mellitus In Children

Johnny Ludvigsson, Lise Heding, Gudrun Liedén, Birgitte Marner and Ake Lernmark
British Medical Journal (Clinical Research Edition)
Vol. 286, No. 6360 (Jan. 15, 1983), pp. 176-178
Published by: BMJ
Stable URL: http://www.jstor.org/stable/29509345
Page Count: 3
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Plasmapheresis In The Initial Treatment Of Insulin-Dependent Diabetes Mellitus In Children
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Abstract

Several factors indicate that autoimmune mechanisms may play a part in the aetiology of insulin-dependent diabetes mellitus. At the onset of the disease in 10 children (aged 11-16 years) plasmapheresis was performed four times over one to two weeks. Seventeen age-matched children with the same clinical features served as controls. The C-peptide concentrations at onset were the same in the two groups, but after one month the children treated with plasmapheresis had significantly higher values. This difference became even more pronounced after three, nine, and 18 months, both during fasting and at the maximum response to a standardised meal. The study group also had a significantly more stable metabolism, longer partial remission, and no higher insulin requirement. Of the 10 treated children islet-cell cytoplasmic antibodies were present in seven before plasmapheresis and in nine during treatment. The antibodies remained detectable in five and six out of nine patients at one and six months respectively after plasmapheresis. Although the mechanisms are obscure, plasmapheresis performed at the onset of insulindependent diabetes mellitus may help to preserve betacell function.

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