The safety and efficacy of plasmapheresis in the treatment of myasthenia gravis is a matter of continuing investigation. Its use in myasthenic crisis in particular is increasingly accepted.1,2 Herein we report the successful use of plasmapheresis during pregnancy in a young woman with unusually fulminant, antibody-negative myasthenia gravis.
REPORT OF A CASE
A 22-year-old, gravida 0 woman had been well except for a one-day episode of vomiting and diarrhea following a picnic. Twelve days later she developed fluctuating dysphagia and dysphonia over the course of one evening. Over the next several days ocular, facial, and limb weakness accumulated and the patient finally was hospitalized near her home. Physical examination and results of repetitive nerve stimulation studies and an edrophonium chloride test were all believed to be consistent with myasthenia gravis. A lumbar puncture disclosed five white blood cells per cubic millimeter and the protein level was 63 mg/dL. The
Levine SE, Keesey JC. Successful Plasmapheresis for Fulminant Myasthenia Gravis During Pregnancy. Arch Neurol. 1986;43(2):197–198. doi:10.1001/archneur.1986.00520020083029
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: