Therapeutic Plasma Exchange in Patients with Severe Fever with Thrombocytopenia Syndrome: A Single Institution Experience

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a novel infection caused by the tick-borne SFTS virus. More than 200 patients are reported every year in Korea, but there is no established treatment. In patients with SFTS, therapeutic plasma exchange (TPE) can be applied. Methods: Clinical and laboratory characteristics of patients diagnosed with SFTS who underwent TPE were analyzed. The factors that can differentiate the prognosis between the patients who recovered after TPE and those who died were analyzed. Results: Ten patients were diagnosed with SFTS and treated with TPE. The mean age was 70.8 (49–85) years, with three men and seven females. The laboratory findings showed a decrease in white blood cell (WBC) count, platelet count, and serum albumin and an increase in AST, ALT, LDH, and CK levels. Patients performed an average of three (2∼4) TPE procedures at intervals of 1∼2 days, three of whom died. Compared to the results at admission, the WBC counts increased after TPE, and the platelet counts remained unchanged. The AST, LDH, and CK levels decreased by 2∼6 fold in the recovered patients and increased in those who died. Among them, the change in LDH was statistically significant between the two groups (P=0.0227). Conclusion: TPE has been used as an adjuvant treatment in SFTS patients who do not have a definitive treatment to date. Additional studies, including small-scale studies such as this study, will be needed to establish the timing, interval, and predictive factors of the effect of TPE. (Korean J Blood Transfus 2021;32:83-90)