OUTCOMES OF THERAPEUTIC PLASMA EXCHANGE IN PATIENTS WITH SEVERE ACUTE EXACERBATION OF SYSTEMIC LUPUS ERYTHEMATOSUS AT BACH MAI HOSPITAL POISON CONTROL CENTER FROM JUNE 2024 TO APRIL 2026

Background: Systemic Lupus Erythematosus (SLE) is a complex systemic autoimmune disease with diverse clinical manifestations and varying levels of severity among patients. Therapeutic Plasma Exchange (TPE/PEX) is considered a supportive treatment modality aimed at rapidly removing autoantibodies, inflammatory cytokines, and circulating immune complexes from the plasma to improve the patient's critical condition. While numerous studies on SLE exist across specialties such as Internal Medicine, Dermatology, and Clinical Immunology, research specifically focusing on TPE for severe acute exacerbations of SLE remains limited. Objectives: To evaluate the treatment outcomes of therapeutic plasma exchange in patients with severe acute exacerbations of SLE and to monitor adverse effects of the procedure within the study group. Methods: A prospective study was conducted on 35 patients diagnosed with severe acute SLE flare-ups who underwent TPE at the Poison Control Center of Bach Mai Hospital from June 2024 to June 2026. Results: Among the 35 patients, females predominated at 91.4% (32 [i]patients), while males accounted for 8.6% (3 patients). The mean age was 31.4 ± 14.9 years (range: 17–71). Patients received an average of 6.77 ± 1.8 TPE sessions (min: 5, max: 13), with 7 sessions being the most frequent (57.1%). Fresh frozen plasma was used as the replacement fluid in 100% of cases. Significant improvements were observed in clinical and laboratory indices: SLEDAI score: Decreased from 23.60 ± 5.53 (pre-TPE) to 10.77 ± 2.20 (post-TPE). Complement C3 (g/L): Increased from 0.45 ± 0.22 (pre-TPE) to 0.90 ± 0.23 (post-TPE). Complement C4 (g/L): Increased from 0.08 ± 0.07 (pre-TPE) to 0.22 ± 0.13 (post-TPE). Anti-dsDNA (UI/mL): Decreased from 118.10 ± 44.88 (pre-TPE) to 28.57 ± 18.19 (post-TPE). Anti-Sm antibody (UI/mL): Decreased from 40.38 ± 32.02 (pre-TPE) to 16.29 ± 14.61 (post-TPE).  Conclusion: Therapeutic plasma exchange is effective for severe SLE flares, with 97.1% (34/35) of patients achieving stability and being transferred to specialized departments for further treatment.