Treatment of refractory myasthenia gravis by double‐filtration plasmapheresis and rituximab: A case series of nine patients and literature review

2020 ◽  
Author(s):  
Hamza N. Bennani ◽  
Emmeline Lagrange ◽  
Johan Noble ◽  
Paolo Malvezzi ◽  
Lionel Motte ◽  
...  
Keyword(s):  
Literature Review ◽  
Myasthenia Gravis ◽  
Case Series ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration

Double filtration plasmapheresis benefits myasthenia gravis patients through an immunomodulatory action

2014 ◽  
Vol 21 (9) ◽  
pp. 1570-1574 ◽  
Author(s):  
Lei Zhang ◽  
Junfeng Liu ◽  
Hongna Wang ◽  
Chongbo Zhao ◽  
Jiahong Lu ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Double Filtration Plasmapheresis ◽  
Immunomodulatory Action ◽  
Double Filtration

scholarly journals Myasthenia Gravis Exacerbation and Myasthenic Crisis Associated With COVID19: Case Series and Literature Review.

2021 ◽  
Author(s):  
Cleonisio Leite Rodrigues ◽  
Hermany Capistrano Freitas ◽  
Paulo Reges Oliveira Lima ◽  
Pedro Helder de Oliveira Junior ◽  
José Marcelino Aragão Fernandes ◽  
...  
Keyword(s):  
Literature Review ◽  
Neuromuscular Junction ◽  
Hospital Mortality ◽  
Myasthenia Gravis ◽  
Viral Infections ◽  
Case Series ◽  
Previous Treatment ◽  
Autoimmune Disorder ◽  
Myasthenic Crisis

Abstract Myasthenia Gravis (MG) is an autoimmune disorder of the neuromuscular junction that can be exacerbated by many viral infections, including COVID19. Management of MG exacerbations is challenging in this scenario. We report 8 cases of MG exacerbation or myasthenic crisis associated with COVID19 and discuss prognosis and treatment based on a literature review. Most patients were female (7/8), with an average age of 47.1 years. Treatment was immunoglobulin (IVIG) in 3 patients, plasma exchange (PLEX) in 2 patients, and adjustment of baseline drugs in 3. In-hospital mortality was 25% and 37.5% in 2-month follow-up. This is the largest case series of MG exacerbation or myasthenic crisis due to COVID19 to this date. Mortality was considerably higher than in myasthenic crisis of other etiologies. Previous treatment for MG or acute exacerbation treatment did not seem to interfere with prognosis, although sample size was too small to draw definitive conclusions. Further studies are needed to understand the safety and effectiveness of interventions in this setting, particularly of PLEX, IVIG, rituximab and tocilizumab.

scholarly journals Management Issues in Myasthenia Gravis Patients Living With HIV: A Case Series and Literature Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Jeannine M. Heckmann ◽  
Suzaan Marais
Keyword(s):  
Literature Review ◽  
Myasthenia Gravis ◽  
Case Series ◽  
Living With Hiv ◽  
Management Issues

Pulmonary function study of myasthenia-gravis patients treated with double-filtration plasmapheresis

2003 ◽  
Vol 18 (3) ◽  
pp. 125-128 ◽  
Author(s):  
Hou-Chang Chiu ◽  
Jiann-Horng Yeh ◽  
Wei-Hung Chen
Keyword(s):  
Pulmonary Function ◽  
Myasthenia Gravis ◽  
Function Study ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration

scholarly journals Apheresis Therapy for Steroid-Resistant Idiopathic Nephrotic Syndrome: Report on a Case Series

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Hamza Naciri Bennani ◽  
Thomas Jouve ◽  
Johan Noble ◽  
Lionel Rostaing ◽  
Paolo Malvezzi ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Minimal Change Disease ◽  
Idiopathic Nephrotic Syndrome ◽  
Case Series ◽  
Calcineurin Inhibitors ◽  
Multidrug Resistant ◽  
Glomerular Permeability ◽  
Steroid Resistant ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration

Idiopathic nephrotic syndrome (INS) represents 15%–30% of adulthood glomerulopathies. Corticosteroids have been the main treatment for decades and are effective in 70% of minimal-change disease patients and ~30% of focal segmental glomerulosclerosis patients. Multidrug-resistant (steroids, calcineurin-inhibitors, cyclophosphamide, mycophenolate-mofetil, rituximab) idiopathic nephrotic syndrome is a major therapeutic challenge in nephrology. Apheresis (double-filtration plasmapheresis or semi specific immunoadsorption) could act by eliminating the circulating factor (apolipoproteinA1b, solubleCD40L, suPAR) increasing glomerular permeability seen in INS. The aim of the study was to report the outcome of three patients with multidrug-resistant INS treated successfully with apheresis.

scholarly journals Immunoglobulin versus Plasmapheresis in treatment of Myasthenia Gravis: a systematic review

2021 ◽  
Author(s):  
Isabella Delfim de Carvalho ◽  
Felipe Iankelevich Baracat ◽  
Lucas Farina Lima
Keyword(s):  
Systematic Review ◽  
Myasthenia Gravis ◽  
Therapeutic Option ◽  
Length Of Hospital Stay ◽  
Treatment Phase ◽  
Ivig Therapy ◽  
Myasthenic Crisis ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration ◽  
Result Analysis

Introduction: Myasthenia Gravis (MG) is an autoimmune and neuromuscular disease. The treatment of immunomodulation consists of intravenous immunoglobulin (IVIg), immunoadsorption (IA), plasmapheresis (PLEX) or double filtration plasmapheresis (DFPP). This systematic review aims to compare therapy modalities in MG crisis. Methods: The studies were identified through research in electronic databases and analyzed individually to clarify their methodological quality (through the Jadad and Newcastle Ottawa scale). Clinical trials randomized or not, and retrospective studies were included. The review included 1,983 patients in nine studies, the result analysis groups were divided into: IVIg x PLEX in the crises; IVIg x PLEX in the pre-thymectomy treatment phase and IVIg x DFPP in the myasthenic crisis. The evaluated outcomes were clinical improvement, adverse effects and length of hospital stay. Results: Immunomodulatory therapy when applied prior to thymectomy was shown to be effective in reducing symptoms and post-thymectomy hospitalization, with IVIg slightly higher, while PLEX showed more side effects. Therapy during crises in both interventions proved to be effective after the 14th start of treatment, in addition to IVIg being slightly superior. Treatment with IVIg was also economically favorable, due to the lower need for hospitalizations. IVIg proved to be inferior to therapy with DFPP and IA, mainly in reducing the need for hospitalization. Conclusion: It is concluded that IVIg therapy is a good therapeutic option in cases of crisis and when available, therapies with DFPP and IA should be the choices, aiming at less complications.

scholarly journals A case of refractory myasthenia gravis positive for anti MuSK antibody that was successfully treated with double filtration plasmapheresis

2007 ◽  
Vol 40 (6) ◽  
pp. 531-535
Author(s):  
Jun Nakagawa ◽  
Takashi Muramatsu ◽  
Keiko Ohta ◽  
Minoru Ando
Keyword(s):  
Myasthenia Gravis ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration
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