Plasma exchange for removal of antibeta1-adrenergic receptor antibody in a small child with dilated cardiomyopathy.

A 5-year-old boy was diagnosed with dilated cardiomyopathy (DCM) at 8 months of age. He underwent plasma exchange (PE) three times during 4 days because his antibeta1-adrenergic receptor antibody titer was 160 times the background density on enzyme-linked immunosorbent assay. BNP titer decreased from 1320 pg/ml before to 506 pg/ml after PE. Dobutamine infusion was discontinued after PE because of improving cardiac function. After PE, his antibeta1-adrenergic receptor antibody titer was < 20 times the background density. When patients have a high titer of antibeta1-adrenergic receptor antibody, PE should be considered, even in small children, as an alternative treatment.