Plasma-exchange in myasthenia gravis: a study in 20 patients

Twenty patients with myasthenia gravis (MG) of generalized 2A and 2B types according to the Ossermann classification were treated with a course of nine plasma exchanges (PE) every two days. Before starting of the course, at the fourth exchange, and at the end of the course, the muscle balance was assessed following a special protocol. Other functions, such as respiratory function, stapedial reflex, phonation, and electro-oculographic activity were assessed and a Desmedt test was done. Three patients showed complete remission of symptoms, 8 showed good improvement and 6 mild improvement. Three showed no improvement. In total 85% of patients gained from PE. The onset of improvement was rapid in all patients but in some it lasted only a short time while in others it persisted for several weeks and even months, without the need for immunosuppressive therapy.