Factors associated with the effectiveness of plasma exchange for the treatment of NMO-IgG-positive neuromyelitis optica spectrum disorders

Mult Scler. 2013 Aug;19(9):1216-8. doi: 10.1177/1352458512471875. Epub 2012 Dec 21.


To identify factors associated with plasma exchange response in neuromyelitis optica (NMO) spectrum disorders, the clinical and magnetic resonance imaging (MRI) features of 31 NMO-IgG-positive patients receiving plasma exchange for steroid-resistant exacerbations were analyzed. Functional improvement was observed in 65% of the patients. A lower baseline Expanded Disability Status Scale score was associated with favorable response (p = 0.040). Patients without cord atrophy had a higher success rate than patients with atrophy (p = 0.016). Levels of NMO-IgG did not differ between responders and non-responders before and after plasma exchange. In conclusion, a minimal pre-existing disability is the primary determinant of the effectiveness of plasma exchange.

Keywords: Plasma exchange; neuromyelitis optica spectrum disorders; neuromyelitis optica-IgG; prognostic factors.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myelitis, Transverse / immunology
  • Myelitis, Transverse / pathology
  • Myelitis, Transverse / therapy*
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / pathology
  • Neuromyelitis Optica / therapy*
  • Plasma Exchange*
  • Recovery of Function / immunology*
  • Retrospective Studies
  • Young Adult


  • Immunoglobulin G