Anti-MuSK Antibody-positive Myasthenia Gravis Successfully Treated with Outpatient Periodic Weekly Blood Purification Therapy

被引：6

作者：

Deguchi, Kentaro ^{[1
]}

Matsuzono, Kosuke ^{[1
]}

Nakano, Yumiko ^{[1
]}

Kono, Syoichiro ^{[1
]}

Sato, Kota ^{[1
]}

Deguchi, Shoko ^{[1
]}

Tanabe, Katsuyuki ^{[2
]}

Hishikawa, Nozomi ^{[1
]}

Ota, Yasuyuki ^{[1
]}

Yamashita, Toru ^{[1
]}

Ohta, Kiyoe ^{[3
]}

Motomura, Masakatsu ^{[4
,5
]}

Abe, Koji ^{[1
]}

机构：

[1] Okayama Univ, Grad Sch Med & Dent, Dept Neurol, Okayama, Japan

[2] Okayama Univ, Grad Sch Med & Dent, Dept Nephrol, Okayama, Japan

[3] Natl Hosp Org Utano Natl Hosp, Clin Res Ctr, Kyoto, Japan

[4] Nagasaki Univ Hosp, Dept Neurol & Strokol, Nagasaki, Japan

[5] Nagasaki Inst Appl Sci, Fac Engn, Dept Engn, Med Engn Course, Nagasaki, Japan

来源：

INTERNAL MEDICINE | 2018年 / 57卷 / 10期

关键词：

myasthenia gravis; periodic weekly blood purification therapy; anti-MuSK antibodies; TYROSINE KINASE MUSK; AUTOANTIBODIES; PLASMAPHERESIS; FEATURES; MG;

D O I：

10.2169/internalmedicine.9466-17

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 37-year-old man with anti-muscle-specific tyrosine kinase (MuSK) antibody-positive myasthenia gravis (MG) presented with subacute progressive dysphagia and muscle weakness of the neck and bilateral upper extremities. Conventional immune-suppressive treatments and high-dose intravenous immunoglobulin were ineffective. He then displayed repeated exacerbations and remissions over the course of two years, despite two to four sessions of plasma exchange (PE) every two months. The patient was successfully treated with outpatient periodic weekly blood purification therapy with alternative PE and double-filtration plasmapheresis using an internal shunt. This case report suggests the benefits of blood purification therapy with an internal shunt against anti-MuSK antibody-positive MG.

引用

页码：1455 / 1458

页数：4

共 22 条

[11] Clinical and experimental features of MuSK antibody positive MG in Japan [J].

Ohta, K. ;

Shigemoto, K. ;

Fujinami, A. ;

Maruyama, N. ;

Konishi, T. ;

Ohta, M. .

EUROPEAN JOURNAL OF NEUROLOGY, 2007, 14 (09) :1029-1034

[12] CLINICAL FINDINGS IN MuSK-ANTIBODY POSITIVE MYASTHENIA GRAVIS: A US EXPERIENCE [J].

Pasnoor, Mamatha ;

Wolfe, Gil I. ;

Nations, Sharon ;

Trivedi, Jaya ;

Barohn, Richard J. ;

Herbelin, Laura ;

McVey, April ;

Dimachkie, Mazen ;

Kissel, John ;

Walsh, Ronan ;

Amato, Anthony ;

Mozaffar, Tahseen ;

Hungs, Marcel ;

Chui, Luis ;

Goldstein, Jonathan ;

Novella, Steven ;

Burns, Ted ;

Phillips, Lawrence ;

Claussen, Gwendolyn ;

Young, Angela ;

Bertorini, Tulio ;

Oh, Shin .

MUSCLE & NERVE, 2010, 41 (03) :370-374

[13] Clinical aspects of MuSK antibody positive seronegative MG [J].

Sanders, DB ;

El-Salem, K ;

Massey, JM ;

McConville, J ;

Vincent, A .

NEUROLOGY, 2003, 60 (12) :1978-1980

[14] Long-term effect of intravenous immunoglobulin on anti-MuSK antibody-positive myasthenia gravis [J].

Shibata-Hamaguchi, A. ;

Samuraki, M. ;

Furui, E. ;

Iwasa, K. ;

Yoshikawa, H. ;

Hayashi, S. ;

Yamada, M. .

ACTA NEUROLOGICA SCANDINAVICA, 2007, 116 (06) :406-408

[15] Acetylcholine receptors loss and postsynaptic damage in MuSK antibody-positive myasthenia gravis [J].

Shiraishi, H ;

Motomura, M ;

Yoshimura, T ;

Fukudome, T ;

Fukuda, T ;

Nakao, Y ;

Tsujihata, M ;

Vincent, A ;

Eguchi, K .

ANNALS OF NEUROLOGY, 2005, 57 (02) :289-293

[16]

Sueoka A, 2000, Ther Apher, V4, P211, DOI 10.1046/j.1526-0968.2000.00218.x

[17] A CLINICAL THERAPEUTIC TRIAL OF CYCLOSPORINE IN MYASTHENIA-GRAVIS [J].

TINDALL, RSA ;

PHILLIPS, JT ;

ROLLINS, JA ;

WELLS, L ;

HALL, K .

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1993, 681 :539-551

[18] Periodic Therapeutic Plasma Exchange in Patients With Moderate to Severe Chronic Myasthenia Gravis Non-Responsive to Immunosuppressive Agents: An Eight Year Follow-Up [J].

Triantafyllou, Nik I. ;

Grapsa, Eirini Ioannis ;

Kararizou, Evangelia ;

Psimenou, Erasmia ;

Lagguranis, Antonios ;

Dimopoulos, Athanasios .

THERAPEUTIC APHERESIS AND DIALYSIS, 2009, 13 (03) :174-178

[19] Seronegative generalised myasthenia gravis: clinical features, antibodies, and their targets [J].

Vincent, A ;

Bowen, J ;

Newsom-Davis, J ;

McConville, J .

LANCET NEUROLOGY, 2003, 2 (02) :99-106

[20] MuSK antibody clearance during serial sessions of plasmapheresis for myasthenia gravis [J].

Yeh, Jiann-Horng ;

Chen, Wei-Hung ;

Chiu, Hou-Chang ;

Bai, Chyi-Huey .

JOURNAL OF THE NEUROLOGICAL SCIENCES, 2007, 263 (1-2) :191-193

← 1 2 3 →