title: Plasmapheresis and immunosuppressive drug therapy in myasthenia gravis.
abstract: Plasmapheresis combined with prednisone and azathioprine therapy produced striking clinical improvement in five patients with myasthenia gravis who still had moderate to severe disability despite thymectomy, high-dose prednisone therapy and optimal doses of cholinesterase inhibitors. Serial determinations of titers of serum antibody toward the acetylcholine receptor demonstrated a fall to 21 +/- 5 per cent (mean +/- S.D.) of the original levels concurrently with the patients' increasing strength. Clinically improved patients maintained lowered titers, whereas clinical relapses were associated with a rebound in titer. Our results suggest that plasmapheresis will find a place in the management of patients with myasthenia gravis, and they implicate antibodies to acetylcholine receptor as a pathogenic factor in this disease.
mesh_terms: D000109:Acetylcholine; D000328:Adult; D001323:Autoantibodies / Q000032:analysis; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D010956:Plasmapheresis; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D011950:Receptors, Cholinergic / Q000276:immunology; D013934:Thymectomy; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic; D001379:Azathioprine; D000109:Acetylcholine; D011241:Prednisone