Immunadsorption bei Kindern und Jugendlichen

Immunoadsorption (IA) is a treatment option of therapeutic apheresis (TA) to selectively remove plasma components from patients’ blood. The possible applications in pediatrics are presented here.

This review article evaluates the scientific evidence on the use of TA in children and adolescents, with particular reference to IA.

Literature search in PubMed.

The IA method is most frequently used for neurological and nephrological indications in pediatrics. Individual case reports or series have mostly been published. Recommendations for the use of TA are mostly based on studies with adult patients. The rationale for the use of IA in neurological diseases is either the direct elimination of the antibody causing the symptoms, e.g., anti-N-methyl-D-aspartic acid (NMDA) receptor encephalitis, or the non-specific removal of antibodies in order to reduce or modulate an overreaction of the immune system against the body’s own tissue (e.g., multiple sclerosis, Guillain-Barré syndrome). Experience in the use of IA in pediatric patients with nephrological diseases is primarily in the treatment of focal segmental glomerulosclerosis (FSGS) and in the field of transplantation for the removal of blood group-mismatched isoagglutinins in preparation for ABO incompatible transplantation and the treatment of antibody-mediated rejection reactions.

With the increasing use of TA, especially IA in pediatrics, it should be possible in the future to evaluate the benefits of this treatment option through prospective observations.