Time course of improved neuromuscular function following plasma exchange alone and plasma exchange with prednisone/azathioprine in myasthenia gravis.
Ten patients with myasthenia gravis (MG) were treated with weekly plasma exchange (PE) in combination with prednisone and azathioprine; 4 of the patients were treated with 3-6 PE alone, before instituting prednisone/azathioprine. Four clinico-physiological parameters of neuromuscular function as well as the anti-acetylcholine receptor antibody (anti-AChRAb) titers were measured 1-3 times per week. Evidence of improved neuromuscular function (NMF) was based on: (1) reduced % decrement of the maximum muscle compound potential following 2/s supramaximal nerve stimulation; (2) increased maximum force; (3) increased outstretched arm time, and (4) increased vital capacity. An early improvement in NMF occurred within the first 2 weeks (sometimes as early as 1-2 days), which was quantitatively comparable in patients treated with PE alone and PE plus prednisone/azathioprine. This early improvement reached a plateau, and was subsequently maintained for 3-4 weeks, followed by a later substantial improvement after 8-12 weeks of combined PE plus prednisone/azathioprine.
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis; D001379:Azathioprine / Q000627:therapeutic use*; D001917:Brachial Plexus / Q000503:physiopathology; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000276:immunology / Q000628:therapy*; D009469:Neuromuscular Junction / Q000187:drug effects / Q000502:physiology*; D010951:Plasma Exchange; D011239:Prednisolone / Q000627:therapeutic use*; D011950:Receptors, Cholinergic / Q000276:immunology; D009435:Synaptic Transmission / Q000187:drug effects*; D014459:Ulnar Nerve / Q000503:physiopathology
D001323:Autoantibodies; D011950:Receptors, Cholinergic; D011239:Prednisolone; D001379:Azathioprine