Plasmapheresis in myasthenia gravis. A comparative study of daily versus alternately daily schedule.
OBJECTIVE
The aim of this study was to compare the efficacy of different protocols of plasmapheresis in the treatment of myasthenia gravis (MG).


METHODS
We treated 30 MG patients with plasmapheresis on either a daily or alternately daily schedule for 5 consecutive sessions. Acetylcholine receptor antibody (AchRAb), serum proteins including albumin, globulin, immunoglobulin G (IgG), IgA, and IgM, and MG score were measured before and after the course of plasmapheresis in each group of patients.


RESULTS
The mean percent reductions of serum proteins including IgA (81.5% vs 69.7%), IgM (95.6% vs 87.1%), and globulin (63.2% vs 50.1%) were significantly higher in the daily group. There were no significant differences in AchRAb and IgG levels after treatment between these 2 groups. However, the reduction of MG score was greater in the daily group. All the patients tolerated plasmapheresis well except for 2.7% of them who experienced hypotension.


CONCLUSIONS
Our results suggest that daily plasmapheresis may be more effective in the treatment of patients with advanced MG.
Yeh
J H
JH
Department of Neurology, Shin-Kong WHS Memorial Hospital, Taipei, Taiwan.
Chiu
H C
HC
D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D016009:Chi-Square Distribution; D002985:Clinical Protocols / Q000592:standards; D005260:Female; D005374:Filtration / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000628:therapy*; D010956:Plasmapheresis / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome