Plasma exchange versus intravenous immunoglobulin treatment in myasthenic crisis
Adnan I. Qureshi(Virginia Commonwealth University Medical Center), Mashkoor A. Choudhry(Emory University), Muhammad Shoaib Akbar(Virginia Commonwealth University Medical Center), Yaseen Mohammad(Emory University), H C Chua(Emory University), Abutaher M. Yahia(Emory University), John A. Ulatowski(Emory University), David A. Krendel(Emory University), Robert T. Leshner(Virginia Commonwealth University Medical Center)
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Abstract
We performed a retrospective multicenter chart review to compare the efficacy and tolerance of plasma exchange (PE) and intravenous immunoglobulin (i.v.Ig) in treatment of 54 episodes of myasthenic crisis. After adjustment for other variables, PE (compared with i.v.Ig) was associated with a superior ventilatory status at 2 weeks (partial F = 6.2, p = 0.02) and 1 month functional outcome (partial F = 4.5, p = 0.04). However, the complication rate was higher with PE compared with i.v.Ig (13 versus 5 episodes, p = 0.07).
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