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Plasma perfusion in myasthenia gravis.
S Passalacqua1, G Splendiani, A Sturniolo
1C.I. Columbus-Rome, Italy.
ASAIO Transactions
|July 1, 1988
Summary
Plasma perfusion effectively improved symptoms in myasthenia gravis (MG) patients resistant to other treatments. This therapy reduced anti-acetylcholine receptor antibodies (anti-AChR-Ab) and improved muscle strength and respiratory function.
Area of Science:
- Neurology
- Immunology
- Medical Technology
Background:
- Myasthenia gravis (MG) is an autoimmune disorder characterized by muscle weakness.
- Patients unresponsive to thymectomy and steroids (Osserman group III) present a treatment challenge.
- Acetylcholine receptor antibodies (anti-AChR-Ab) play a crucial role in MG pathogenesis.
Purpose of the Study:
- To evaluate the efficacy of plasma perfusion (PP) in treating severe, treatment-resistant myasthenia gravis.
- To assess the impact of PP on clinical symptoms, respiratory function, and immunological markers.
Main Methods:
- Seven patients with severe MG underwent a treatment cycle of six plasma perfusion sessions.
- Plasma was perfused through a column to adsorb anti-AChR-Ab.
- Clinical assessments included muscle strength, respiratory function, and electromyography (RSS) before and after treatment.
Main Results:
- All patients showed clinical improvement in bulbar symptoms and respiratory function after 1-3 PP sessions.
- Limb muscle strength improved subsequently.
- Significant reductions were observed in serum concentrations of anti-AChR-Ab, IgA, IgG, IgM, C3, and C4 post-treatment.
Conclusions:
- Plasma perfusion is an effective therapeutic option for myasthenia gravis patients refractory to conventional treatments.
- PP leads to sustained clinical improvement in a majority of patients, with antibody reduction correlating with symptom relief.
- Relapses can occur but are often manageable with retreatment.