Plasma exchange and Vitamin D loss: Plasma exchange represents an important therapeutic strategy in a variety of autoimmune conditions. The technique itself effectively removes medium and large molecular weight proteins including pathogenic autoantibodies. However, as part of collateral damage, it may also remove physiologically relevant human proteins. Hiemstra and colleagues report in the journal the novel observation that plasma exchange induces an acute reversible decrease in plasma 1,25-dihydroxyvitaminD, Vitamin-D Binding Protein (DBP) and a sustained decrease in plasma 25-hydroxyvitamin D.
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