Plasma Exchange of Malignant Multiple Sclerosis

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Abstract
A 17-yr old female with malignant multiple sclerosis died 45 wk after the onset of the disease. Postmortem examination confirmed the clinical diagnosis of multiple sclerosis. After 30 wk of rapid clinical progression, the patient was treated with 2 courses of plasma exchange therapy without immunosuppression. This form of therapy caused a drop in CSF myelin basic protein levels in 1 instance, but not in another. Controlled clinical trials are required to determine whether plasma exchange therapy is of value in the management of patients with multiple sclerosis. The monitoring of CSF myelin basic protein, if elevated, may be 1 useful marker to follow as part of these studies.