Masanori Nakagawa
Japan
Case Report
A Case of Refractory Generalized Myasthenia Gravis Treated with Polypharmacy and Plasma Exchange
Author(s): Koushun Matsuo, Chihiro Fujii, Kiyonori Miyata, Yuka Kawasaki Segawa, Hiroshi Kado, Tsuguru Hatta, Yu Sato, Rei Yasuda, Masanori Nakagawa and Toshiki MizunoKoushun Matsuo, Chihiro Fujii, Kiyonori Miyata, Yuka Kawasaki Segawa, Hiroshi Kado, Tsuguru Hatta, Yu Sato, Rei Yasuda, Masanori Nakagawa and Toshiki Mizuno
A 62-year-old man with myasthenia gravis (MG) was admitted with dyspnea, bulbar symptoms (dysphagia and dysarthria), and subsequent muscular weakness of the limbs. Results for anti-acetylcholine receptor antibody and muscle-specific kinase antibody were negative. We introduced periodic plasma exchange as a new therapeutic strategy. Once double-filtration plasmapheresis (DFPP) was adopted, effects became notable, but the response shortened over time. After stepwise increases in PSL up to 60 mg/day with insulin, the interval between DFPP was prolonged from 1 week to 2 weeks. DFPP was significantly beneficial in this case. Combining several effective methods can optimize therapeutic effects against refractory MG... View More»
