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Updated: May 15, 2026

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Published on: March 14, 2017
Safety of plasma exchange therapy in patients with myasthenia gravis
Hamid Ebadi1, David Barth, Vera Bril
1Division of Neurology, University Health Network, University of Toronto, 5EC-309, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.
Introduction:
Plasma exchange (PLEX) is effective in myasthenia gravis (MG), but there are concerns about its safety.
Methods:
We collected data prospectively from 42 patients randomized to PLEX treatment in a comparison study with intravenous immunoglobulin (IVIg). Detailed information on the PLEX treatment methodology and adverse events are reported.
Results:
Forty of 42 patients completed PLEX. Ninety percent were treated in an outpatient setting. Fifty-five percent had no complications, and 45% had mild-moderate reactions that did not require stopping treatment; the majority were citrate reactions and peripheral vascular issues that were easily treated. Fifty-seven percent of patients responded to treatment, and 83% completed PLEX via peripheral venous access. Two patients had severe adverse events: 1 related and 1 unrelated to PLEX. Comorbid disease and age did not predict reactions.
Conclusion:
PLEX is safe, effective, and well tolerated in patients with MG. Our results do not raise concerns about the safety of PLEX in patients with moderate-severe MG.
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