INTRODUCTION: Systemic lupus erythematosus (SLE) associated with autoimmune thyroid disease (AITD) is a complex and well recognized autoimmune disorder. Careful monitoring/surveillance of thyroid gland functioning and active treatment of SLE patients with coexisting AITD, typically using medications, are critically important. The role of apheresis in this setting remains to be fully explored. Here we examine the use of double-filtration plasmapheresis (DFPP), as an adjuvant therapy in the treatment of patients with SLE complicated with AITD and report our experiences using this apheresis methodology. METHODS: We performed a retrospective chart review of 11 patients with SLE complicated with AITD who had received DFPP in our blood purification center between 2004 and 2008. Levels of thyroid hormones, antithyroid autoantibodies, SLE disease activity, proteinuria, glomerular filtration rate (GFR), and response to therapy were analyzed. RESULTS: AITD, SLE, and lupus nephritis improved after DFPP. Except for one patient who died of severe pneumonia in the second month after completion of DFPP, all surviving patients continued to show clinical improvements or remained stable during the follow-up periods. CONCLUSION: DFPP can effectively remove autoantibodies and may have an important adjuvant role in therapeutic options in the treatment of SLE patients with AITD complications.
INTRODUCTION:Systemic lupus erythematosus (SLE) associated with autoimmune thyroid disease (AITD) is a complex and well recognized autoimmune disorder. Careful monitoring/surveillance of thyroid gland functioning and active treatment of SLEpatients with coexisting AITD, typically using medications, are critically important. The role of apheresis in this setting remains to be fully explored. Here we examine the use of double-filtration plasmapheresis (DFPP), as an adjuvant therapy in the treatment of patients with SLE complicated with AITD and report our experiences using this apheresis methodology. METHODS: We performed a retrospective chart review of 11 patients with SLE complicated with AITD who had received DFPP in our blood purification center between 2004 and 2008. Levels of thyroid hormones, antithyroid autoantibodies, SLE disease activity, proteinuria, glomerular filtration rate (GFR), and response to therapy were analyzed. RESULTS: AITD, SLE, and lupus nephritis improved after DFPP. Except for one patient who died of severe pneumonia in the second month after completion of DFPP, all surviving patients continued to show clinical improvements or remained stable during the follow-up periods. CONCLUSION:DFPP can effectively remove autoantibodies and may have an important adjuvant role in therapeutic options in the treatment of SLEpatients with AITD complications.