臨床神経学

<シンポジウム(2)―1―3>重症筋無力症:臨床の問題点とその解決法

血液浄化法と免疫グロブリン

松尾 秀徳

独立行政法人国立病院機構長崎川棚医療センター〔〒859―3615 長崎県東彼杵郡川棚町下組郷2005番地1〕

Plasmapheresis (PP) and intravenous immunoglobulin (IVIG) are both effective for treatment of crisis and acute exacerbation of myasthenia gravis. The 1st clinical problem is that effect of both treatments usually lasts for only 2-3 weeks. Additional immunosuppressive treatments may be necessary for prevention of the relapse. The 2nd problem is adverse effects and complications associated with each treatment. Hypotension, including shock, thromboembolism, and opportunistic infections are major adverse events of PP. Awareness of these complications and careful practice should be solutions. IVIG complicates less adverse effects than PP. The cost of each treatment, which is expensive particularly in IVIG use, may become the 3rd problem. It should be important to clarify the appropriate number of PP and the dose of IVIG to improve myasthenic crisis.
Full Text of this Article in Japanese PDF (188K)

(臨床神経, 52:1051−1052, 2012)
key words:重症筋無力症,治療

(受付日:2012年5月24日)