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Plasma exchange in myasthenia gravis: changes in serum complement and immunoglobulins
Author(s) -
Thorlacius S.,
Mollnes T. E.,
Garred P.,
Aarli J. A.,
Matre R.,
Tönder O.,
Halvorsen K.
Publication year - 1988
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 - 10.1111/j.1600-0404.1988.tb03650.x
Subject(s) - myasthenia gravis , complement system , ic3b , antibody , medicine , chemistry , immunology , complement (music) , endocrinology , immunoglobulin m , immunoglobulin g , biochemistry , complementation , gene , phenotype
ABSTRACT‐ Serum concentrations of C4, IgG, IgA, and IgM were followed in 8 selected patients with myasthenia gravis (MG) during a 5‐day course of plasma exchange (PE), using donor plasma as a replacement solution. C3 activation products (C3b, iC3b and C3c) and the terminal SC5b‐9 complement complex were measured in 4 of the patients. All patients improved during the treatment, including 2 patients without detactable antibodies to AChR in serum. The main findings of the study were marked complement activation and an approximately 50% fall in the serum concentrations of IgM and C4 during PE, independent of the concentrations in the donor plasma. The concentrations of IgG and IgA did not change significantly. The fall in C4 during PE is presumably caused by C4 consumption. We postulate that the fall in IgM is an effect of a complement‐induced vasodilatation and that PE‐induced complement consumption may influence the effect of PE in patients with MG.