CHILDHOOD MULTIPLE-SCLEROSIS TREATED WITH PLASMAPHERESIS

We report a case of multiple sclerosis in a 7-year-old boy. He experie nced three episodes in 8 months and was repeatedly treated with a high dose of methylprednisolone, During the third episode, to avoid the si de effects associated with frequent high doses of steroid, we substitu ted plasmapheresis for methylprednisolone, initially performing it for 3 days and continuing it every 2 to 3 weeks according to the fluctuat ing values of antinuclear antibody, The patient improved markedly afte r initiation of plasmapheresis and has been relapse-free for more than 18 months. The effectiveness of plasmapheresis for treatment of multi ple sclerosis in adults is variable and has seldom been reported in ch ildren, Our case suggests that plasmapheresis as an alternative therap y is useful for steroid-dependent or severe types of multiple sclerosi s even in childhood, especially when its chronic course is assessed by antinuclear antibody titers. (C) 1997 by Elsevier Science Inc. All ri ghts reserved.