Plasma Exchange in Primary Biliary Cirrhosis

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Abstract
To the Editor: We have been studying a 55-year-old woman with a diagnosis of primary biliary cirrhosis and features of scleroderma. She had a normal pulmonary x-ray film but a severely reduced diffusion capacity, resulting in arterial hypoxemia. It occurred to us that this abnormality might be due to deposition of immune complexes containing high levels of IgM1 in the lung capillaries, and we decided to treat her with repeated plasma exchanges. This treatment resulted in a somewhat improved diffusion capacity and a considerably improved hepatocellular function as assessed with the [14C]aminopyrine breath test2 (normal range in our laboratory, . . .