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August 13, 1982

Cooling, then culling blood complexes combats arthritis

JAMA. 1982;248(6):632. doi:10.1001/jama.1982.03330060010006

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Apheresis to treat patients with rheumatoid arthritis continues to intrigue investigators, although the procedure is considered experimental and the subset of patients who may benefit needs to be identified.

In one trial reported at the Pan-American Congress of Rheumatology in Washington, DC, a variation called cryopheresis that is used to remove circulating immune complexes achieved "significant improvement in clinical parameters" in 14 of 16 patients whose conditions previously had failed to improve on at least one major therapeutic regimen. The study was conducted by Randall Krakauer, MD, of the Cleveland Clinic Foundation, and associates in other cities.

The technique, Krakauer explained, takes advantage of the cryoprecipitability of some immune complexes: when plasma is separated from other blood elements with a hollow filter and cooled to 0.7°C, immune complexes come out of solution and can be removed by centrifugation or filtration. The remainder of the plasma is reheated and returned to