Myasthenic Crisis with Delayed Recovery after Plasmapheresis

Autor: Matsuo, H., Goto, H., Ohtsuru, I., Izumoto, H., Fukudome, T., Fujishita, S., Shibuya, N.
Zdroj: Therapeutic Apheresis and Dialysis; November 01, 1999, Vol. 3 Issue: 4 p326-328, 3p
Abstrakt: We report on 2 elderly patients with myasthenia gravis in whom recovery from crisis was prolonged despite intensive plasmapheresis (PP). In both patients, the anti-acetylcholine (anti-AChR) titer failed to fall sufficiently after completing PP. These patients might have had antibodies that produced a more pronounced effect on the degradation of AChR, or the synthesis of AChR might have been reduced by aging. The anti-AChR titer did not correlate with a reduction of IgG after PP in 1 patient. Successful treatment was achieved by keeping the anti-AChR titer at a low level via the concomitant use of prednisolone with PP.
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