Plasma exchange in macroglobulinemia patients is recommended to remove what?

In patients with macroglobulinemia, particularly those with conditions like Waldenström's macroglobulinemia, there is an overproduction of immunoglobulin M (IgM). Plasma exchange is a therapeutic procedure designed to remove excess proteins, antibodies, or other substances from the plasma. The goal of plasma exchange in these patients is specifically to reduce the viscosity of the blood caused by the elevated levels of IgM immunoglobulins.

By removing the excess IgM from the circulation, plasma exchange helps mitigate symptoms associated with hyperviscosity syndrome, such as blurred vision, headaches, dizziness, and can also improve the overall clinical condition of the patient.

In contrast, the other options do not address the specific issue stemming from macroglobulinemia. Antigens may play a role in various immune responses, but they are not the primary target in this context. IgG does not typically accumulate in the same way in macroglobulinemia; instead, it usually involves excess IgM. Abnormal platelets may be present in various hematological conditions, yet they are not specifically targeted or removed through plasma exchange in these patients. Thus, the focus of the procedure is clearly on the removal of excess IgM.