Effects of Plasmapheresis on the Acetylcholine Receptor Antibody and Clincal Course in Myasthenia Gravis

J Korean Neurol Assoc > Volume 11(2); 1993 > Article

Journal of the Korean Neurological Association 1993;11(2): 187-194.

중증근무력증에서 혈장교환 치료법에 따른 아세틸콜린 수용체 항체 역가 및 임상증세의 변화

이근호, 이광우

서울대학교 신경과.

Effects of Plasmapheresis on the Acetylcholine Receptor Antibody and Clincal Course in Myasthenia Gravis

Geun-Ho Lee, M.D., Kwang-Woo Lee, M.D.

Department of neurology , College of medicine, Seoul National University

Abstract

It is known that in myasthenia gravis(MG) the plasmapheresis therapy removes the acetylcholine receptor (AChR) antibodies and other toxins in the serum to cause clinical improvement temporarily. To know the effects of plasmapheresis on AChR antibody and clinical courses the authors checked serially the AChR antibody titers and clinical stages in myasthenia gravis. The plasmapheresis were performed for the therapeutic purposes in seven and elective purposes in three MG subjects. After two, three or four cycles of plasmapheresis, the myasthenic symptoms have dramatically improved in all subjects. However the AChR antibody titers decreased in only four out of ten and the decremental ratio in each case uas rather smaller than being expected. Thus the effects of plasmapheresis could not be explained solely by the decreasing phenomena of AChR antibody titers in MG subjects. Therefore the authors assumed that the clinical severities of MG could be correlated with other types of AChR antibodies that are not checked by the routine @-bungarotoxin binding technique, or the AChR antibodies are secondarily produced in large amount by the mechanism of rebound enhancing activity.