[pubmed] Myasthenia Gravis Exacerbation in Association with Antibody Overshoot Following Plasmapheresis

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[pubmed] Myasthenia Gravis Exacerbation in Association with Antibody Overshoot Following Plasmapheresis

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Muscle Nerve. 2021 Jun 2. doi: 10.1002/mus.27341. Online ahead of print.

ABSTRACT

INTRODUCTION: Antibody overshoot following therapeutic plasmapheresis (PLEX) is defined by subsequent increase in antibody to levels exceeding those prior to removal. It has been infrequently described in the past, and its influence on the clinical course of myasthenia gravis (MG) remains unclear.

METHODS: This was a retrospective analysis of 5 patients with generalized MG treated with PLEX.

RESULTS: All 5 patients possessed antibodies against acetylcholine receptor (AChR-Ab). After undergoing 3 to 12 PLEX treatment sessions, AChR-Ab titer increased to a median of 1,292% of the baseline level. The median interval from last PLEX session to peak AChR-Ab detection was 6 weeks. In 4 patients, AChR-Ab overshoot was associated with a clinical deterioration.

DISCUSSION: Acetylcholine receptor antibody overshoot may occur following PLEX. In patients who deteriorate following PLEX treatment, the presence of antibody overshoot may serve as additional guidance for treatment adjustment. This article is protected by copyright. All rights reserved.

PMID:34076268 | DOI:10.1002/mus.27341


Source: https://pubmed.ncbi.nlm.nih.gov/3407626 ... 6&v=2.14.4
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