Caution on Plasmapheresis for Myasthenia Gravis

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Abstract
To the Editor: Nationwide publicity about plasmapheresis therapy for myasthenia gravis, following upon the article by Dau et al.,1 requires that several points be strongly emphasized to physicians trying to deal with the resultant expectations of patients with this disease.In the first place, plasmapheresis is risky. Repeated exchanges usually require the use of an arteriovenous shunt as well as large amounts of heterogeneic plasma or plasma substitutes. Patients undergoing plasmapheresis are exposed to potentially serious risks of rapid blood loss, coagulation defects, clot embolism, electrolyte imbalance, allergic reactions, hepatitis and other infections. In my experience the probability is large . . .

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