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Previous Volume 297:1134-1140 November 24, 1977 Number 21 Next

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Abstract

Plasmapheresis combined with prednisone and azathioprine therapy produced striking clinical improvement in five patients with myasthenia gravis who still had moderate to severe disability despite thymectomy, high-dose prednisone therapy and optimal doses of cholinesterase inhibitors. Serial determinations of titers of serum antibody toward the acetylcholine receptor demonstrated a fall to 21 +/- 5 per cent (mean +/- S.D.) of the original levels concurrently with the patients' increasing strength. Clinically improved patients maintained lowered titers, whereas clinical relapses were associated with a rebound in titer. Our results suggest that plasmapheresis will find a place in the management of patients with myasthenia gravis, and they implicate antibodies to acetylcholine receptor as a pathogenic factor in this disease.

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• Richman, D. P., Agius, M. A. (2003). Treatment of autoimmune myasthenia gravis. Neurology 61: 1652-1661 [Abstract] [Full Text]  
• Clark, W. F., Rock, G. A., Buskard, N., Shumak, K. H., LeBlond, P., Anderson, D., Sutton, D. M., for the Canadian Apheresis Group*, (1999). Therapeutic Plasma Exchange: An Update from the Canadian Apheresis Group. ANN INTERN MED 131: 453-462 [Abstract] [Full Text]  
• Ferrero, B., Aimo, G., Pagni, R., Bergamasco, B., Bongioanni, M. R., Bergamini, L., Durelli, L. (1997). Modified and improved anti-acetylcholine receptor (AChR) antibody assay: comparison of analytical and clinical performance with conventional anti-AChR antibody assay. Clin. Chem. 43: 824-831 [Abstract] [Full Text]  
• Drachman, D. B. (1994). Myasthenia Gravis. NEJM 330: 1797-1810 [Full Text]