Role of Therapeutic Plasma Exchange in the Treatment of Myasthenia Gravis: A Tertiary Hospital - Based Observational Study

This study aimed to analyze the experience related to the indication, complication, and outcome of Therapeutic Plasma Exchange (TPE) in Myasthenia gravis (MG). Plasma exchange is the therapeutic modality established in MG with a positive recommendation based on a strong consensus of class 3 evidence. A total of 15 patients of MG were submitted to a total of 17 cycles and 65 sessions of TPE. It was performed using a single volume plasma exchange with intermittent cell separator (Hemonetics) by Femoral or central line access and scheduled preferably on alternate day intervals. The immediate outcome was assessed shortly after each session and the overall outcome at discharge. A total of 26 patients of MG were admitted to our hospital during the study period of two years.15 (57.69%) patients had TPE performed with a mean age of 32 years (M: F = 3: 1). The mean number of TPE sessions was 4.2 (SD?1.2), volume exchange was 2215 ml (SD?435), the overall incidence of adverse reaction was 21.7%. All patients had immediate benefits from each TPE cycle. Good acceptance of the procedure was observed in 78.3% of patients. TPE may be considered as one of the treatment options, especially in developing countries like ours, as it is relatively less costly but as effective for myasthenic crisis as other modalities.