Clinical observation of protein A immunoadsorption in treatment of myasthenia gravis

Objective To evaluate the efficacy of protein A immunoadsorption on myasthenia gravis.Methods A total of 24 myasthenia gravis cases were divided into two groups: The treatment group (n=12) and thecontrol group (n=12). Patients in both groups were treated with the traditional therapy, but those in the treatmentgroup received protein A immunoadsoption 3 times per week for 4 weeks. Serum immunoglobulins of IgG, IgA andIgM, complements of C3 and C4, and antibodies against nicotinic acetylcholine receptor were determined beforeand after the treatment. The efficacy of protein A immunoadsorption on myasthenia gravis patients was evaluated bya scoring system based on physical examinations. Results The overall rate of effectiveness was 91.67% in thetreatment group and 75% in the control group (P0.05). The numbers of patients showing complete recovery,significant recovery, improvement, response and no response were 5, 2, 3, 1 and 1, respectively, in the treatmentgroup, and were 2, 2, 2, 3 and 3, respectively, in the control group. Serum IgG, IgA and IgM and antibodies againstthe nicotinic acetylcholine receptor decreased more remarkably in the treatment group than in the control group (P0.01). Conclusions Protein A immunoadsorption significantly lowered serum IgG, IgA, IgM and antibodiesagainst the nicotinic acetylcholine receptor, and shortened the disease course in myasthenia gravis patients. Therefore,it is an effective method and can be used in association with the traditional therapy for myasthenia gravis patients.