[Plasmapheresis in combined treatment of severe generalized myasthenia]

Experience in the application of plasmapheresis in various stages of treatment is analysed. It was conducted in 52 patients with severe forms of generalized myasthenia; 12 of them were males and 40 were females. It is noted that plasmapheresis is very effective in the preoperative period for the preparation of patients for operation and is ineffective in medicamentous therapy. In the late-term periods after thymectomy plasmapheresis is mainly recommended for arresting crises and precritical conditions because of the rapid and short effect of the method. In patients who underwent thymectomy and splenectomy the effect of plasmapheresis in the late-term period after the operation was of a longer duration. Research must be continued and clinical experience accumulated to identify exactly the mechanism of the effect of plasmapheresis on the myasthenic status and the immune and neuroendocrine systems and to determine the place of the method in the complex of therapeutic measures.