Hyperchloremic metabolic acidosis following plasma exchange during myasthenia gravis crisis

J Clin Apher. 2016 Oct;31(5):479-80. doi: 10.1002/jca.21432. Epub 2015 Sep 22.

Abstract

Background: Therapeutic plasma exchanges are increasingly used, notably during myasthenia gravis crisis. Repeated exchanges may induce severe adverse events.

Case: We reported a case of symptomatic hyperchloremic metabolic acidosis following a therapeutic plasma exchange. Analysis of 4% albumin substitution solution revealed a chloride concentration of 145 mmol/L, which could explain this acidosis.

Discussion: Infusion of high volume of 4% albumin during plasma exchanges may produce hyerchloremic metabolic acidosis.

Conclusion: Special attention should be paid when repeated plasma exchanges are performed. J. Clin. Apheresis 31:479-480, 2016. © 2015 Wiley Periodicals, Inc.

Keywords: acid-base disorders; hyperchloremic metabolic acidosis; myasthenia gravis; plasma exchange.

Publication types

  • Case Reports

MeSH terms

  • Acidosis / etiology*
  • Adult
  • Chlorides / analysis*
  • Female
  • Humans
  • Myasthenia Gravis / complications
  • Myasthenia Gravis / therapy*
  • Plasma Exchange / adverse effects*
  • Serum Albumin
  • Solutions / chemistry

Substances

  • Chlorides
  • Serum Albumin
  • Solutions