Therapeutic Apheresis in Myasthenia Gravis

Abstract

Plasmapheresis has considerably improved the management of patients affected by myasthenia gravis (MG), particularly in case of severe acute worsening with bulbar impairment. Controlled trials against placebo are not available in this field, but evidences emerged from open-label studies are considered a strong confirmation of the clinical efficacy of plasmapheresis in MG. More recently, the techniques of selective apheresis based on the properties of protein A and sheep anti-human IgG have been introduced into clinical practice, allowing chronic apheresis in treatment-resistant MG patients.