Pheresis

The term 'Pheresis' is of Greek origin and it means 'to take away' or 'separate'. Pheresis is a special kind of blood donation. The specific components of blood namely the plasma, erythrocytes, platelets, granulocytes, agranulocytes are separated. In this procedure, the blood component needed to diagnose a suspected abnormality or treat a known disease is separated and the remaining blood is returned to the donor. Pheresis can also be described as a blood purification process.

During pheresis, whole blood is collected from one arm of the donor and this goes into a machine called 'cell separator'. The blood is spun in the machine and components separated and after the desired component is collected into a special bag, the red cells and other components are returned to the donor. As most blood is returned to the donor, pheresis facilitates a donor to donate more of a specific component. There are two main types of pheresis. One is removal of platelets - platelet pheresis and removal of plasma - plasmapheresis.

Plateletpheresis: This is especially used in patients who have leukemia or aplastic anemia and are receiving chemotherapy. They need platelets as cancer and cancer treatments can deplete the body of platelets. Platelets are necessary to prevent potentially fatal bleeding problems. Platelet is a very precious component of blood that can be stored only for five days and only about one tablespoon of platelet can be collected from one unit.

Plasmapheresis: Otherwise known as therapeutic plasma exchange, in plasmapheresis, the cells from the straw colored liquid portion of the blood which contains the clotting factors, infection fighting antibodies and other proteins are removed. Plasma is necessary to regulate blood pressure and maintain the mineral balance in the body. Fresh frozen plasma is also administered to control disseminated intravascular coagulation.

A flexible tube is inserted into the donor's arm. Blood is slowly drawn into a sophisticated machine which separates various components of blood. Each pheresis donation is typed and marked for a specific patient. Both plasmapheresis and plateletpheresis can be conducted in a hospital or blood donation center. There are certain preparatory procedures that a donor needs to follow before undergoing pheresis. He/she should get a good night's sleep, eat a balanced diet, drink plenty of caffeine-free liquids. A donor is also advised not to consume aspirin within 72 hours or ibuprofen within 24 hours before undergoing pheresis. After the donation, the pheresis donor may feel tired for a few hours. The donor should not plan on driving home after the procedure. Heavy lifting or strenuous exercise need be avoided until the following day.

Hemolytic Anemia

Hemolytic anemia is a kind of anemia that occurs when there is high rate of destruction of RBC. Infections of Streptococcus or other conditions can lead the body to destroy its own RBC. Hemolytic anemia can enlarge the spleen that results in increased destruction of red blood cells (Hemolysis). Some complications of this Anemia:
Pain
Shock
Gallstones

Persons suffering hemolytic condition might experience severe fatigue, dizziness, shortness of breath and chest pain. A complete blood count can help in identifying hemolytic anemia. Hemolytic anemia is treated with lifestyle changes and medicines. In more severe cases blood transfusion and plasmapheresis might be resorted to.

Autoimmune Hemolytic Anemia : Warm antibody hemolytic anemia, one of the most common types afflicting women, results when the body produces auto antibodies that coat red blood cells which in turn are destroyed by the spleen, liver or bone marrow. Many of these patients also have leukemia, lupus, lymphoma or connective tissue disease. In cold antibody hemolytic anemia, the body targets red blood cells at or below normal body temperature - often to patients who have had pneumonia, mononucleosis or other acute infections. Exposure to cold temperatures can accelerate red blood cell destruction resulting in fatigue, discoloration of limbs and joint pains.

Sideroblastic Anemia: In this anemia, the body has sufficient iron but it fails to incorporate it into hemoglobin.

Myasthenia Gravis

Myasthenia Gravis is an auto immune disease characterized by attack on the nerve-muscle junction. Myasthenia gravis involves weakness and fatigue of any group of voluntary muscles. This condition tends to worsen with activity and improves with rest. Muscles that are usually involved include those that control eyelid movement, facial expressions, swallowing and talking. Breakdown in the communication between muscles and nerves is caused by antibodies produced by the immune system. The production of these antibodies is believed to originate from the thymus gland.

Typical symptoms of MG include drooping eyelids, unstable gait or change in facial expressions. The patient suffering from Myasthenia gravis may experience fatigue on repetitive movements and muscle weakness in the limbs. There may be signs of double vision. Some patients suffer from slurred speech and difficulty in swallowing or speaking. In severe cases, neck muscles and muscles controlling breathing can be affected.

Often diagnosis of myasthenia gravis takes time since the symptoms are mistaken for those of other neurological disorders. Blood test to check for the presence of immune molecules or acetylcholine receptor antibodies aids in detecting any excessive levels of antibodies. The edrophonium test involves injection of edrophonium into the muscle to find out whether the cause for muscular weakness is MG. An EMG (electromyography) is used to diagnose myasthenia gravis by checking for impaired nerve-muscle transmission. Spirometry aids in assessing the respiratory function to check if the patient's respiratory muscles re affected.

Treatment for MG hinges on the patient's age and the muscles that are affected as well as severity of the muscle weakness. Myasthenia gravis can be controlled with medications such as immunosuppressive drugs and anticholinesterase agents. A surgical removal of the thymus gland helps in reducing symptoms in many patients suffering from Myasthenia Gravis. In severe cases of myasthenia gravis, Plasmapheresis is resorted to. Here, the blood of the patient is passed through a filter to remove some antibodies. Another form of therapy is to provide the patient with intravenous immune globulin to alter the response of the immune system.