PMID- 30779438
OWN - NLM
STAT- MEDLINE
DCOM- 20200115
LR  - 20200115
IS  - 1098-1101 (Electronic)
IS  - 0733-2459 (Linking)
VI  - 34
IP  - 4
DP  - 2019 Aug
TI  - Excellent response to therapeutic plasma exchange in myasthenia gravis patients 
      irrespective of antibody status.
PG  - 416-422
LID - 10.1002/jca.21694 [doi]
AB  - INTRODUCTION: The primary objective of this study was to assess response to 
      plasma exchange (PLEX) in myasthenia gravis (MG) patients with and without 
      autoantibodies (Ab) to acetylcholine receptor (AChR) or muscle-specific kinase 
      (MuSK). Analysis was also done to determine if correlation existed between sex, 
      early or late onset MG, thymoma, or thymectomy and response to PLEX. MATERIALS 
      AND METHODS: Data was analyzed on 58 consecutive MG patients treated with PLEX. 
      Responses were categorized as complete response, clinical improvement requiring 
      maintenance PLEX, or no/minimal response to PLEX. RESULTS: Eighty-eight percent 
      (51/58) of patients were Ab-positive; 44 had AChR and 7 had MuSK Ab. Complete 
      response was seen in 26 patients (24 Ab+), 24 remain on maintenance PLEX (19 
      Ab+), and 2 had no/minimal response (both AChR Ab+). Ab status (P = 0.43), AChR 
      Ab (P = 0.10), MuSK Ab (P = 0.45), early onset MG (P = 0.63), thymoma (P = 0.46), 
      and thymectomy (P = 0.16) were not significantly associated with outcome. Patient 
      sex did show significant association with outcome (P = 0.01), with men more 
      likely to have complete response and women more likely to require maintenance. 
      Late onset MG is significantly associated with higher likelihood of complete 
      response (P = 0.03). Antibody titers declined after PLEX in 83% of patients with 
      complete response, in whom pre- and post-PLEX titers were available (n = 6). 
      CONCLUSIONS: In conclusion, our study showed 96% response rate to PLEX in MG; 
      however, only patient gender and late onset MG were significantly associated with 
      treatment response.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Usmani, Amena
AU  - Usmani A
AUID- ORCID: 0000-0002-3170-6482
AD  - Department of Pathology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - Kwan, Laura
AU  - Kwan L
AD  - Department of Pathology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - Wahib-Khalil, Dina
AU  - Wahib-Khalil D
AD  - Department of Pathology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - Trivedi, Jaya
AU  - Trivedi J
AD  - Department of Neurology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - Nations, Sharon
AU  - Nations S
AD  - Department of Neurology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
FAU - Sarode, Ravi
AU  - Sarode R
AD  - Department of Pathology, University of Texas Southwestern Medical Center, Dallas, 
      Texas.
LA  - eng
PT  - Journal Article
DEP - 20190219
PL  - United States
TA  - J Clin Apher
JT  - Journal of clinical apheresis
JID - 8216305
RN  - 0 (Autoantibodies)
RN  - 0 (Receptors, Cholinergic)
RN  - EC 2.7.10.1 (MUSK protein, human)
RN  - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
SB  - IM
MH  - Adult
MH  - Age of Onset
MH  - Autoantibodies/*blood
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myasthenia Gravis/diagnosis/*therapy
MH  - Plasma Exchange/*standards
MH  - Prognosis
MH  - Receptor Protein-Tyrosine Kinases/immunology
MH  - Receptors, Cholinergic/immunology
MH  - Sex Factors
MH  - Thymectomy
MH  - Thymoma
MH  - Treatment Outcome
OTO - NOTNLM
OT  - acetylcholine receptor antibody (AChR)
OT  - muscle specific kinase (MuSK) antibody
OT  - myasthenia gravis (MG)
OT  - plasma exchange
EDAT- 2019/02/20 06:00
MHDA- 2020/01/16 06:00
CRDT- 2019/02/20 06:00
PHST- 2018/05/01 00:00 [received]
PHST- 2018/11/30 00:00 [revised]
PHST- 2018/12/03 00:00 [accepted]
PHST- 2019/02/20 06:00 [pubmed]
PHST- 2020/01/16 06:00 [medline]
PHST- 2019/02/20 06:00 [entrez]
AID - 10.1002/jca.21694 [doi]
PST - ppublish
SO  - J Clin Apher. 2019 Aug;34(4):416-422. doi: 10.1002/jca.21694. Epub 2019 Feb 19.