葡萄球菌蛋白A免疫吸附治疗难治性重症肌无力一例

A case report of staphylococcal protein A immunoadsorption therapy for refractory myasthenia gravis

葡萄球菌蛋白A(SPA)对人免疫球蛋白具有高度亲和力,SPA免疫吸附可以特异性降低自身抗体效价,迅速缓解重症肌无力(MG)的临床症状。最近有研究发现与血浆置换相比,免疫吸附有更好的临床疗效和更低的不良反应发生率。在此报道1例对皮质类固醇激素、静脉注射免疫球蛋白及免疫抑制治疗反应差的难治性MG患者,患者病程后期免疫功能低下、肺部感染进行性加重。给予4次免疫吸附治疗后呼吸肌无力症状迅速缓解。结合文献复习探讨了免疫吸附在治疗难治性MG中的价值。

Staphylococcal protein A(SPA)has a high affinity for human immunoglobulin,and SPA immunoadsorption can specifically reduce the titer of autoantibodies and quickly relieve the clinical symptoms of myasthenia gravis(MG).Recent studies have suggested that immunoadsorption has better clinical efficacy and a lower incidence of adverse reactions than plasma exchange.A case of refractory MG with poor response to corticosteroids,intravenous immunoglobulins and immunosuppressive therapy was reported.The patient had low immune function and progressive pulmonary infection in the later stage of the disease.Respiratory muscle weakness was relieved quickly after four times of immunoadsorption therapy.The value of immunoadsorption in the treatment of refractory MG was explored with literature review.