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August 1993

Myasthenic Crisis: Response to Plasmapheresis Following Failure of Intravenous γ-Globulin

Author Affiliations

From the Division of Immunotherapy, Department of Medicine, California Pacific Medical Center (Drs Stricker, Kwiatkowska, and Kiprov), and the Department of Medicine, Kaiser Permanente Medical Center (Dr Habis), San Francisco.

Arch Neurol. 1993;50(8):837-840. doi:10.1001/archneur.1993.00540080046012

• Myasthenic crisis is a potentially life-threatening complication of myasthenia gravis that requires aggressive therapy. We describe four patients in whom myasthenic crisis developed and who failed to respond to initial treatment with intravenous γ-globulin. All four patients subsequently responded to intensive plasma exchange. Based on our experience, plasmapheresis appears to be superior to intravenous γ-globulin for the treatment of myasthenic crisis in certain patients. Prognostic factors that determine the effectiveness of intravenous γ-globulin vs plasmapheresis in these patients merit further investigation.

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