click below
click below
Normal Size Small Size show me how
ASFA guidelines
TQs
Question | Answer |
---|---|
Inflammatory demyelinating disorder characterized by attacks within spinal cord and optic nerve. Symptoms of myelitis include paraparesis and sensory loss below the lesion, sphincter loss, dyesthesia, and radicular pain. | Neuromyelitis optica spectrum disorders (NMOSD), previously neuromyelitis optica (NMO) and Devic’s disease |
ASFA category of NMO | Category II |
autoantibody against _______________ is pathogenic in NMOSD. | aquaporin-4 (AQP4; NMO-IgG), the principal water channel on astrocyte foot processes at blood brain barrier, is pathogenic in NMOSD |
Current diagnostic criteria for Neuromyelitis optica are: | optic neuritis, acute myelitis, and at least two of three supportive criteria: contiguous spinal cord MRI lesions extending over 3 vertebral segments, brain MRI not meeting diagnostic criteria for MS, and NMO-seropositive status. |
Acute attacks of NMO are managed by: | high-dose intravenous steroids (usually intravenous pulse steroids (methylprednisone 1 g daily 3 5 days followed by oral steroid taper) and, if symptoms fail to resolve, TPE is added. |
If a clinician asks you to do apheresis, you should | examine the evidence |
ASFA Category for disorders for which apheresis is accepted as first-line therapy, either as a primary standalone treatment or in conjunction with other modes of treatment. | ASFA Category 1 |
ASFA Category for disorders for which apheresis is accepted as second-line therapy, either as a standalone treatment or in conjunction with other modes of treatment. | ASFA Category II |
ASFA Category for when the optimum role of apheresis therapy is not established. Decision making should be individualized. | ASFA Category III |
ASFA Category for Disorders in which published evidence demonstrates or suggests apheresis to be ineffective or harmful. IRB approval is desirable if apheresis treatment is undertaken in these circumstances. | ASFA Category IV |
The only Category I indication in the treatment of acute complications of sickle cell disease | stroke |