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Plasmapheresis should be attempted in severe refractory cases of myasthenia gravis even when acetylcholine receptor antibody (AChRab) levels are not elevated in the serum.
This is because another form of antibody may be involved in some cases of this disease, Peter Kornfeld, MD, told JAMA MEDICAL NEWS, and there could be still others.
Kornfeld, a speaker at the World Neurology Congress in Kyoto, Japan, said he has used plasmapheresis in seven patients having normal AChRab levels with good results.
This discovery is the latest from a series of studies in which Kornfeld and his group at the Myasthenia Gravis Clinic at Mount Sinai Medical Center in New York have been studying the role of plasmapheresis in myasthenia gravis patients who do not respond to thymectomy, corticosteroids, or anticholinesterase drugs.
In an earlier series of 16 patients with refractory, generally severe myasthenia gravis, Kornfeld got an excellent clinical response in 12
McCann J. Another antibody in myasthenia gravis sera?. JAMA. 1982;247(9):1237. doi:10.1001/jama.1982.03320340009005