Is there a role for plasmapheresis in SLE?
In patients with lupus nephritis, the addition of plasmapheresis to treatment with immunosuppressive agents has shown no proven benefit.
However, plasmapheresis has been beneficial in patients with lupus cerebritis, SLE-associated thrombotic thrombocytopenic purpura, and diffuse alveolar hemorrhage.
The American Society for Apheresis lists severe systemic lupus as a category II recommendation (accepted as second-line therapy, either as a stand-alone treatment or in conjunction with other modes of treatment), whereas lupus nephritis is listed as a category IV recommendation (disorders in which published evidence demonstrates or suggests apheresis to be ineffective or harmful).
