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IMMUNOADSORPTION IN THE TREATMENT OF MYASTHENIA GRAVIS
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Abstract
Myasthenia gravis (MG) is an autoimmune disease that affects the neuromuscular junction. Glucocorticoids and immunosuppressants are the mainstay of MG treatment; however, these drugs do not immediately treat myasthenic symptoms. Therefore, for severe acute exacerbations, including myasthenic crisis, plasmapheresis (PP) and intravenous immunoglobulin (IVIg) are used for short-term treatment. IA or IVIg immunoadsorption is used to treat acute MG. We report 4 cases of acute myasthenic crisis diagnosed with positive AChR antibody tests, classified as class V according to the Myasthenia Gravis Foundation of America criteria (MGFA), who were followed up for clinical evaluation during treatment with immunoadsorption, which can selectively remove immunoglobulins from plasma. The results showed that immunoadsorption improved clinical symptoms of myasthenia gravis; Therefore, fresh frozen plasma transfusion is not necessary, and side effects such as allergic reactions can be avoided.
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Keywords
Immunoadsorption, HA280 cartridge, myasthenia gravis
References
2. Kohler W, Bucka C, Klingel R (2011). A randomized and controlled study comparing immunoadsorption and plasma exchange in myasthenic crisis. J Clin Apheresis.; 26:347-355.
3. Lazaridis K, Baltatzidou V, Tektonidis N, Tzartos SJ (2020). Antigen-specific immunoadsorption of MuSK autoantibodies as a treatment of MuSK-induced experimental autoimmune myasthenia gravis. Journal of Neuroimmunology, 339:577136.
4. Jaretzki A 3rd, Barohn RJ, Ernstoff RM, Kaminski HJ, Keesey JC, et al. (2000) Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Ann Thorac Surg.; 70:327-334.
5. Splendiani G, Passalacqua S, Barbera G, Sturniolo A, Costanzi S, Bartoccioni E, Casciani CU (1991). Myasthenia Gravis (MG) Treatment with Immunoadsorbent Columns. Biomater Artif Cells Immobilization Biotechnol.; 19(1):255-265.
6. Haas M, Mayr N, Zeitlhofer J, Goldammer A, Derfler K (2002). Long-term treatment of myasthenia gravis with immunoadsorption. Journal of Clinical Apheresis; 17(2):84-87.
7. Liu JF, Wang WX, Xue J, et al. (2010). Comparing the autoantibody levels and clinical efficacy of double filtration plasmapheresis, immunoadsorption, and intravenous immunoglobulin for the treatment of late-onset myasthenia gravis. Ther Apher Dial.; 14:153-160.
8. Yasuda M, Uzawa A, Ozawa Y, Kojima Y, Onishi Y, Akamine H, Kuwabara S (2021). Immunoadsorption apheresis versus intravenous immunoglobulin therapy for exacerbation of myasthenia gravis, Scandinavian Journal of Immunology; 95(2):e13122.
9. Uzawa A, Akamine H, Kojima Y, Ozawa Y, Yasuda M, Onishi Y,… Kuwabara S (2021). High levels of serum interleukin-6 are associated with disease activity in myasthenia gravis. Journal of Neuroimmunology; 358:577634.