{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:45:06Z","timestamp":1787755506681,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute transverse myelitis (ATM), acute flaccid myelitis with polio\u2010like myeloradiculitis (AFM) and Guillain\u2010Barr\u00e9 syndrome (GBS) are severe neuroimmune disorders associated with high morbidity. First\u2010line treatments include corticosteroids and intravenous immunoglobulins (IVIg), but they may be insufficient. Therapeutic plasma exchange (TPE) and immunoadsorption (IA) are second\u2010 or third\u2010line options in pediatrics, despite their recognized efficacy in adults. Data on pediatric use remain limited. This study aimed to evaluate the efficacy and safety of apheresis in children with ATM, GBS or AFM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective monocentric study at Necker University Hospital, including pediatric patients diagnosed with ATM, GBS or AFM who underwent TPE\/IA between 2014 and 2024. Functional outcomes were assessed using the modified Rankin Scale (mRS) at five time points, from peak disease severity to last follow\u2010up. Safety was evaluated based on severe adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 23 children (6\u2009years [Q1\u2010Q3]), 20 received TPE and 3 IA. 17 of 23 patients (74%) showed significant improvement by the end of treatment. The median mRS was 5 (IQR 4\u20135) before apheresis, improving to 4 (IQR 2\u20134) at the end of TPE\/IA, and decreasing to 2 at 6\u2009months. Brainstem function fully recovered in all surviving patients. Among 14 children with sphincter dysfunction, 5 (36%) still required intermittent catheterization. No treatment discontinuations occurred, but two patients died, one from venous air embolism, one after life\u2010sustaining treatment limitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TPE and IA appear effective in pediatric ATM, AFM and GBS. Larger studies are needed to confirm long\u2010term efficacy and refine treatment guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70406","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:06:16Z","timestamp":1763463976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Plasmapheresis in Children With Acute Transverse or Flaccid Myelitis, and Guillain\u2010Barr\u00e9 Syndrome"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0418-065X","authenticated-orcid":false,"given":"Alix","family":"Fleurance","sequence":"first","affiliation":[{"name":"Pediatric Neurology Department Necker\u2010Enfants Malades University Hospital, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Joseph","sequence":"additional","affiliation":[{"name":"Biotherapy Department Necker University Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laur\u00e8ne","family":"Dehoux","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Department Necker University Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Barnerias","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department Necker\u2010Enfants Malades University Hospital, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Hully","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department Necker\u2010Enfants Malades University Hospital, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoelle","family":"Kossorotoff","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department Necker\u2010Enfants Malades University Hospital, APHP  Paris 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Necker Hospital, Necker University Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florine","family":"Perez","sequence":"additional","affiliation":[{"name":"Pediatric Neuroly Department CHU of Montpellier, Montpellier University  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Colmard","sequence":"additional","affiliation":[{"name":"Pediatric Neuroly Department CHU of Montpellier, Montpellier University  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Meyer","sequence":"additional","affiliation":[{"name":"Pediatric Neuroly Department CHU of Montpellier, Montpellier University  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Jokic","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Centre Hospitalier Universitaire de Caen  Caen 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