Clinical Remission After Therapeutic Apheresis in a [ME/CFS] Patient : A Case Report, 2024, Burgard

Sly Saint

Sly Saint

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Clinical Remission After Therapeutic Apheresis in a Patient Suffering from Long Term Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Case Report


Abstract: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating multifactorial illness characterized by profound fatigue persisting for more than six months, post-exertional malaise, cognitive impairments, and a range of systemic symptoms. Until now, no accepted causal treatment regimens have been available; therapeutic options include different approaches, such as alleviation of symptoms and promotion of energy conservation. In this study, we report the case of a 49-year-old female presented to our center suffering from ME/CFS for more than 15 years, characterised by a strong energy loss and neurological and systemic symptoms; previous therapies remained unsuccessful. Therefore, we decided to perform double-filtration apheresis. After comprehensive laboratory evaluation, including investigation of persistent viral infections, the patient was treated eight times with double-filtration apheresis within a period of 2 years, which resulted in a remarkable sustained clinical remission and significant improvement in her quality of life. Therefore, we conclude that double-filtration apheresis could be an effective therapeutic tool for the treatment of ME/CFS.

https://www.dovepress.com/clinical-...ffering--peer-reviewed-fulltext-article-IMCRJ
 
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The paper reads as something written by someone who understands nothing about interpreting immunological tests. It is a sort of shaman with a wand meets high tech lab on a dark night stuff. Unsurprisingly coming from German private practice.
 
forestglip said:
Can you give any specific examples of what they got wrong?
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Not really, I would have to quote the entire account. It is all meaningless. There was no evidence of inflammation. Autoantibodies to adrenergic receptors are of no known relevance - they occur in normals as much as disease. Assays for immune complex containing C3d were abandoned for clinical use decades ago because nobody knew what the test meant. And so on.
 
rvallee said:
8 times over a period of 2 years is not a useful result. Way too many factors that could be involved.
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The paper reports an improvement in swelling even after the first aphaeresis. I guess it's possible that this person did experience benefits as a result of the treatment, even if all the measurements and science-y autoantibody stuff reported are completely irrelevant.

It isn't clear to me if the woman had ME/CFS - there are symptoms that aren't commonly reported such as a rash and tremors. We don't know how many people with a diagnosis of ME/CFS were treated and did not report any benefit. A single case study in the context of an author with a conflict of interest is cherry picking on steroids.

Unfortunately this isn't useful evidence.
 
In anyone going through apheresis for any reason and getting some kind of effect of any kind, it would be interesting to know what was actually filtered out of the patient's blood. If that isn't investigated then it all seems like a complete waste of time from a research point of view.
 
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