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ASFA guidelines

TQs

QuestionAnswer
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
Created by: jfshikle