Pinching A J, Peters D K
Lancet. 1976 Dec 25;2(8000):1373-6. doi: 10.1016/s0140-6736(76)91917-6.
A course of daily plasma-exchange was undertaken in 3 patients with severe myasthenia gravis (M.G.) who had failed to respond to anticholinesterases, thymectomy, and steroids. In the 2 cases with acquired M.G., exchange was associated with an unequivocal improvement in muscle weakness and fatiguability, indicating that a humoral factor in plasma is directly concerned in causing the disorder of neuromuscular transmission. The improvement began within a few days of initiating exchange and continued for several days after exchange ceased. Preliminary evidence suggests that the beneficial effect can be maintained with subsequent immunosuppressive therapy. The patient with congenital M.G. failed to improve, suggesting that its pathogenesis may differ from that of the acquired disease.
对3例重症肌无力（MG）患者进行了每日血浆置换疗程，这些患者对抗胆碱酯酶、胸腺切除术和类固醇治疗均无反应。在2例获得性MG患者中，血浆置换与肌无力和易疲劳性的明确改善相关，表明血浆中的一种体液因子直接参与了神经肌肉传递障碍的发生。改善在开始置换后的几天内开始，并在置换停止后持续了几天。初步证据表明，后续免疫抑制治疗可维持有益效果。先天性MG患者没有改善，提示其发病机制可能与获得性疾病不同。
