Double filtration plasmapheresis in the treatment of myasthenic crisis--analysis of prognostic factors and efficacy.
OBJECTIVE
To examine the prognostic factors and outcome of myasthenia gravis (MG) patients in crisis with double filtration plasmapheresis (DFP) treatment.


METHODS
A total of 15 patients experienced 20 episodes of crisis during the study period. Plasmapheresis was carried out using a double filtration


METHODS
Demographic information, clinical features of crisis, and associated complications were analyzed.


RESULTS
The median duration of crisis was 9 days. Chest infection was the most common precipitant of crisis. Twelve out of the 20 episodes (60%) responded well to DFP and mechanical ventilation was discontinued after the third session of DFP in 8 of them. Three significant predictors for prolonged crisis were shorter intervals between the onset of MG and the first crisis (P=0.04), higher serum bicarbonate levels at baseline (P=0.03) and the thymic pathology of thymoma (P=0.03).


CONCLUSIONS
DFP can ameliorate the profound weakness in crisis and seems to be a rational therapy for patients with myasthenic crisis.
Yeh
J H
JH
Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Chen
W H
WH
Chiu
H C
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005374:Filtration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000628:therapy*; D010951:Plasma Exchange; D010956:Plasmapheresis / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome