Myasthenic crisis. Response to plasmapheresis following failure of intravenous gamma-globulin.
Myasthenic crisis is a potentially life-threatening complication of myasthenia gravis that requires aggressive therapy. We describe four patients in whom myasthenic crisis developed and who failed to respond to initial treatment with intravenous gamma-globulin. All four patients subsequently responded to intensive plasma exchange. Based on our experience, plasmapheresis appears to be superior to intravenous gamma-globulin for the treatment of myasthenic crisis in certain patients. Prognostic factors that determine the effectiveness of intravenous gamma-globulin vs plasmapheresis in these patients merit further investigation.
Stricker
R B
RB
Department of Medicine, California Pacific Medical Center, San Francisco, 94120.
Kwiatkowska
B J
BJ
Habis
J A
JA
Kiprov
D D
DD
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000276:immunology / Q000628:therapy*; D010956:Plasmapheresis; D011950:Receptors, Cholinergic / Q000276:immunology
D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous; D011950:Receptors, Cholinergic