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Background and Objective: Progressive increase of iron stores leads to the development of varied diseases, some of them irreversible. Until now, phlebotomy has been the cornerstone in the treatment of iron overload. Nevertheless, each erytrhocytapheresis procedure removes more than twice the volume of red cells and iron than phlebotomy, allowing to achieve iron depletion in shorter time. Our aim was to describe clinical features and analytical tests parameters of patients with iron overload, to analyze global and subsets results, to suggest predictive factors of response and to evaluate security of the procedure., Patients and Method: Descriptive, longitudinal and prospective study of 663 procedures corresponding to 35 patients (December 2002 to October 2011). Response was defined as a serum ferritine value lower than 50 ng/mL during two months. Statistical analysis was done with SPSS(®) v 17.0 and the minimum level of statistical significance was defined as p-value < 0,05., Results: Seventy-seven percent of patients reached response with 11 (interquartile range 1-42) erytrhocytapheresis procedures and at 11 (1-108) months. Eighty-seven point five percent of patients who did not achieve response had their ferritine values reduced in more than 50%. The decrease of all iron metabolism parameters was statistically significant. Statistically significant predictive factors of response to erytrhocytapheresis were: patients younger than 60 years-old, hereditary hemochromatosis cases, and patients who had received treatment with phlebotomies prior to erytrhocytapheresis., Conclusions: Erytrhocytapheresis is a secure and effective procedure for iron depletion in patients with iron overload, especially in high risk hereditary hemochromatosis cases that do not respond to phlebotomies., (Copyright © 2013 Elsevier España, S.L. All rights reserved.)

Background and Objective: The high mortality attributable to severe malaria by Plasmodium falciparum is related to the grade of parasitemia. Automated erithrocytapheresis (AE) is a safe alternative to exchange transfussion, with the same potential benefits but less undesirable side effects. Literature on this technique is scarce, consisting of isolated reports or short series. The objective of this study is to describe the clinical picture and outcome observed in 6 severely ill malaria patients in whom EA was applied as complimentary therapeutic technique., Patients and Method: An observational prospective descriptive study was carried out of all inpatients with severe malaria in a single hospital between 1996 and 2006 in whom clinical, epidemiological and parsitological data were analyzed., Results: This series included 2 women and 4 men, with a median age of 43 years. In all cases, the infection was acquired in West Sub-Saharan Africa. No patient had received antimalarial prophylaxis and all were infected by Plasmodium falciparum. The grade of parasitemia was between 10% and 35%. The number of severity criteria was between one and 4, the more frequent being hyperbilirrubinemia. All patients received conventional intravenous treatment. The total length of admission oscillated between 5 and 37 days, while the length of stay in the Intensive Care Unit varied between one and 17 days. All patients survived., Conclusions: AE is a safe technique, with the same advantages that blood exchange but lacking many of its disadvantages. A isolated parasitemia above 10%, or when a parasitaemia above of 5% is associated with any additional World Health Organization-2000 criteria of clinical severity, should constitute an indication for AE.

Objective: To assess the feasibility of granulocyte apheresis (GCAP) in patients with Ocular Behçet's Disease (BD) resistant to immunosuppressive therapy (prednisone, cyclosporin, azathyoprine or mycophenolate mofetil)., Methods: Prospective observational study of five cases, carried out in a university centre. Four patients were resistant to medical treatment and one refused immunosuppressive drugs. The intervention procedure consisted of an extracorporeal GCAP using a column filled with cellulose acetate beads (Adacolumn, JIMRO, Takasaki, Japan). All patients received underwent a schedule of therapy of five sessions, once a week for five consecutive weeks. Visual acuity (Snellen lines), the degree of intraocular inflammation and doses of immunosuppressive therapy were measured and observed every week., Results: Visual acuity improved in the five cases. Intraocular inflammation was measured and observed in every case, relapses were avoided, and treatment with prednisone was reduced by more than half of the initial dose (average reduction 52.7%, SD 14)., Conclusions: GCAP has been shown to be safe and effective as a new therapy in five cases of Ocular Behçet's Disease refractory to medical treatment. Further research is needed in order to confirm the promising results of these initial investigations.