Myasthenic crisis with delayed recovery after plasmapheresis.
We report on 2 elderly patients with myasthenia gravis in whom recovery from crisis was prolonged despite intensive plasmapheresis (PP). In both patients, the anti-acetylcholine (anti-AChR) titer failed to fall sufficiently after completing PP. These patients might have had antibodies that produced a more pronounced effect on the degradation of AChR, or the synthesis of AChR might have been reduced by aging. The anti-AChR titer did not correlate with a reduction of IgG after PP in 1 patient. Successful treatment was achieved by keeping the anti-AChR titer at a low level via the concomitant use of prednisolone with PP.
Matsuo
H
H
Department of Neurology, Kawatana National Hospital, Japan.
Goto
H
H
Ohtsuru
I
I
Izumoto
H
H
Fukudome
T
T
Fujishita
S
S
Shibuya
N
N
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007163:Immunosorbent Techniques; D008297:Male; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010956:Plasmapheresis / Q000379:methods*; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome