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Horm Metab Res 2019; 51(12): 779-784
DOI: 10.1055/a-1039-1471
Review

Metabolic and Non-Metabolic Peripheral Neuropathy: Is there a Place for Therapeutic Apheresis?

Richard Straube
1   Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum – Cham, Germany
,
Gregor Müller
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
,
Karin Voit-Bak
1   Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum – Cham, Germany
,
Sergey Tselmin
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
,
Ulrich Julius
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
,
Ulrike Schatz
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
,
Hannes Rietzsch
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
,
Heinz Reichmann
3   Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
,
George P. Chrousos
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
4   University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
,
Annette Schürmann
5   Department of Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
,
Luka Jarc
6   Center for Regenerative Therapies Dresden, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
,
Tjalf Ziemssen
3   Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
,
Timo Siepmann
3   Department of Neurology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
,
Stefan R. Bornstein
2   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany
7   Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
8   Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, University Hospital, Zürich, Switzerland
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Abstract

As the rate of obesity and the incidence of diabetes mellitus have been increasing, diabetic neuropathy has become the most common cause of peripheral neuropathy in developed countries. In addition, a variety of pathogenetically heterogeneous disorders can lead to impairment of the peripheral nervous system including amyloidosis, vitamin deficiencies, uremia and lipid disorders, alcohol abuse, autoimmune and infectious diseases as well as exposure to environmental toxins. We have noted that a combination of these disorders may aggravate the manifestations of peripheral diabetic neuropathy, an effect, which is most pronounced when metabolic and non-metabolic pathologies lead to cumulative damage. Current treatment options are limited and generally have unsatisfactory results in most patients. Therapeutic apheresis (INUSpherese®) allows the removal of metabolic, inflammatory, immunologic and environmental contributors to the disease process and may be an effective treatment option. We reviewed the developments in therapeutic apheresis for metabolic and non-metabolic peripheral neuropathy, including the current literature as well as data from our university diabetes center.

Key words

apheresis - neuropathy - lipids


Publication History

Received: 01 October 2019

Accepted: 29 October 2019

Article published online:
11 December 2019

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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