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Predictable recovery from myasthenia gravis crisis with plasma exchange: Thirty‐six cases and review of current management
Author(s) -
Mahalati Kathy,
Dawson R. Ben,
Collins John O.,
Mayer Richard F.
Publication year - 1999
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/(sici)1098-1101(1999)14:1<1::aid-jca1>3.0.co;2-u
Subject(s) - myasthenia gravis , medicine , azathioprine , plasmapheresis , cholinesterase , therapeutic plasma exchange , thymectomy , anesthesia , immunology , surgery , antibody , disease
Adult, acquired, idiopathic, autoimmune myasthenia gravis has a well‐characterized IgG anti‐acetylcholine striated‐muscle receptor antibody. Removal by plasma exchange is effective, established therapy to augment anti‐cholinesterase and immunosuppressive therapy and is the treatment of choice for myasthenia gravis crisis. We report 36 consecutive patients referred and accepted for plasma exchange, 32 of whom were in or entering myasthenia crisis, over a 10 year period. An average of 7.8 (range 1 to 16) plasma exchange procedures were done, with uniform, significant improvement, including extubation of 13 in myasthenic crisis and discharge from hospital in all. We conclude that this is the best treatment for myasthenia gravis crisis in hospital. From recent cases, most, if not all, crises can be prevented by IVIgG or plasma exchange as out‐patients with use of corticosteroid and or azathioprine. J. Clin. Apheresis 14:1–8, 1999. © 1999 Wiley‐Liss, Inc.