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Double filtration plasmapheresis in the treatment of myasthenic crisis – analysis of prognostic factors and efficacy
Author(s) -
Yeh JH.,
Chen WH.,
Chiu HC.
Publication year - 2001
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1034/j.1600-0404.2001.104002078.x
Subject(s) - plasmapheresis , myasthenia gravis , medicine , thymoma , weakness , mechanical ventilation , anesthesia , surgery , immunology , antibody
Objectives – To examine the prognostic factors and outcome of myasthenia gravis (MG) patients in crisis with double filtration plasmapheresis (DFP) treatment. Material and methods – A total of 15 patients experienced 20 episodes of crisis during the study period. Plasmapheresis was carried out using a double filtration method. Demographic information, clinical features of crisis, and associated complications were analyzed. Results – The median duration of crisis was 9 days. Chest infection was the most common precipitant of crisis. Twelve out of the 20 episodes (60%) responded well to DFP and mechanical ventilation was discontinued after the third session of DFP in 8 of them. Three significant predictors for prolonged crisis were shorter intervals between the onset of MG and the first crisis ( P =0.04), higher serum bicarbonate levels at baseline ( P =0.03) and the thymic pathology of thymoma ( P =0.03). Conclusion – DFP can ameliorate the profound weakness in crisis and seems to be a rational therapy for patients with myasthenic crisis.