A short plasma exchange protocol is effective in severe myasthenia gravis

Abstract

Plasma exchange has been reported to be a successful therapeutic procedure for the treatment of severely compromised myasthenic patients, but the optimal regimen in terms of costs or clinical benefit has not so far been determined. We have investigated the efficacy of a short plasmapheresis protocol of two exchanges 1 day apart in a series of 70 patients with severe forms of myasthenia gravis. Patients were evaluated before and 7 days after the first exchange. A positive outcome was observed in 70% of the plasma exchange cycles performed. Disease severity did not seem to be a negative prognostic factor for the efficacy of this short protocol, which was well tolerated by patients. In only 1 case were major side-effects observed. In spite of its short duration, the exchange treatment plus concomitant immunosuppressive drug therapy was not followed by early clinical deterioration.

Therapeutic plasma exchange in neuro-immunological disorder

“…Out of 21 patients, 17 patients (81%) improved and 4 patients failed to improve after TPE for 2 weeks which was very similar to our result. 8 Behan PO et al studied Twenty-one patients with myasthenia gravis underwent a course of plasma exchange combined with immunosuppressive therapy. In fifteen (71%) there was dramatic clinical improvement which has been maintained for periods up to 19 months.…”

Plasmaféresis indicada por enfermedad neurológica: Experiencia de 140 procedimientos en 47 pacientes

“…La plasmaféresis es útil en MG en 3 situaciones especiales: a) Crisis miasténica con debilidad severa y compromiso bulbar o respiratorio [11][12][13][14][15] ; b) Como tratamiento intermitente a largo plazo, en pacientes con mala respuesta a anticolinesterásicos, corticoides e inmunosupresores 16,17 ; y c) Preparación preoperatoria 17,18 .…”

Optimal volume of processed plasma and total number of selective plasmapheresis sessions in the treatment of patients with severe generalized Myasthenia Gravis

“…The selection of the technical parameters of plasmapheresis in the treatment of patients with MG varies widely due to the lack of sufficient data from controlled studies to standardize the plasmapheresis procedure [ [4][5][6][7]. The choice of plasmapheresis protocol is often empirical.…”

“…The choice of plasmapheresis protocol is often empirical due to the lack of data from objective and controlled comparisons among different protocols [4,5]. There have been few controlled studies, which compared the efficacy among different plasmapheresis protocols [4,6,7].…”