MYASTHENIC CRISIS - RESPONSE TO PLASMAPHERESIS FOLLOWING FAILURE OF INTRAVENOUS GAMMA-GLOBULIN

Myasthenic crisis is a potentially life-threatening complication of my asthenia gravis that requires aggressive therapy. We describe four pat ients in whom myasthenic crisis developed and who failed to respond to initial treatment with intravenous gamma-globulin. All four patients subsequently responded to intensive plasma exchange. Based on our expe rience, plasmapheresis appears to be superior to intravenous gamma-glo bulin for the treatment of myasthenic crisis in certain patients. Prog nostic factors that determine the effectiveness of intravenous gamma-g lobulin vs plasmapheresis in these patients merit further investigatio n.