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Myasthenia gravis (MG) treatment with immunoadsorbent columns.
G Splendiani1, S Passalacqua, G Barbera
12d Università Tor Vergata, C.I. Columbus, Roma.
Summary
Plasma perfusion effectively improved muscle strength and respiratory function in most patients with Myasthenia Gravis (MG) and anti-acetylcholine receptor antibodies. Some patients maintained improvement long-term, while others relapsed and responded to re-treatment.
Area of Science:
- Neurology
- Immunology
- Medical Technology
Background:
- Myasthenia Gravis (MG) is an autoimmune disorder characterized by autoantibodies against acetylcholine receptors (anti-AChR-AB).
- Severe MG (Osserman group III-IV) often necessitates aggressive treatment post-thymectomy and immunosuppression.
- The efficacy of plasma perfusion (PP) in refractory MG requires further investigation.
Purpose of the Study:
- To evaluate the clinical and immunologic effects of plasma perfusion (PP) in patients with severe Myasthenia Gravis (MG).
- To assess the long-term efficacy and durability of PP treatment in MG patients with high anti-AChR-AB levels.
Main Methods:
- Ten plasma perfusion (PP) treatments were administered to eight severe MG patients with high anti-AChR-AB.
- Clinical assessments included muscle strength, ventilatory function, and electromyography before and after PP.
- Immunologic markers were monitored throughout the treatment cycles.
Main Results:
- Patients with anti-AChR-AB showed significant improvements in muscle strength and respiratory function post-PP.
- One patient without specific antibodies did not improve and was excluded.
- Four patients maintained clinical benefits for 16-24 months; two relapsed but responded to re-treatment.
Conclusions:
- Plasma perfusion is a potentially effective therapy for severe anti-AChR-AB positive Myasthenia Gravis.
- PP offers sustained clinical improvement in a significant proportion of MG patients.
- Recurrence of symptoms may necessitate repeat PP treatments, which can be effective.