Skill Checkup: A 57-Year-Old Woman With Dyspnea, Droopy Right Eye, and Mild Crackles at Both Lower Lung Fields

Raghav Govindarajan, MD


May 06, 2022

Plasmapheresis is believed to act by removing circulating humoral factors (ie, anti-acetylcholine receptor antibodies and immune complexes) from the circulation. It is used as an adjunct to other immunomodulatory therapies and as a tool for crisis management.

Immunosuppressive therapy, which may include corticosteroids (eg, prednisone), azathioprine, mycophenolate mofetil, tacrolimus, and cyclosporine, is commonly used for treatment of myasthenia gravis and may be used with cholinesterase inhibitors. Generally, corticosteroids result in rapid improvement in the first 2 months of therapy, while the other immunosuppressive drugs require many months to over a year to be effective. Patients receiving long-term therapy with such medications require ongoing monitoring to help prevent or appropriately treat adverse side effects.

Physical therapy may be recommended to help patients maintain muscle strength and range of motion but must be performed in a manner that limits any overexertion.

Most patients with myasthenia gravis have a near-normal life span. Only 3-4 out of every 100 people with the condition die because of it.

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