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13 In 1993, The Journal of Clinical Apheresis published a paper detailing the use of TPE as either a first- or second-line therapy to be used with other modalities on disorders such as Raynauds disease, systemic lupus erythematosus, coagulation factor inhibitors, familial hypercholesterolemia, acute Guillain-Barr syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, cryoglobulinemia, Goodpastures syndrome, and thrombotic thrombocytopenic purpura

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One month later, nivolumab (100 mg per 21 days), a PD1 inhibitor, was added to the patients treatment regimen, and the patient showed a good tolerance response