Type-I hypersensitivity reactions in crisis myasthenic gravis patients after Therapeutic Plasma Exchange (TPE): a case report
Main Article Content
Keywords
Myasthenic Crisis, Therapeutic Plasma Exchange, Type I Hypersensitivity, Urticaria
Abstract
Background: Therapeutic Plasma Exchange (TPE) is one of the acute management procedure for patients with Myasthenia Gravis (MG) crisis where the side effects after the procedure are quite minimal. This case report discusses a type-I hypersensitivity reaction that occurred after TPE in a patient with Myasthenia Gravis (MG) crisis.
Case Presentation: A 56-year-old woman with myasthenia gravis (MGFA grade V) was admitted with respiratory distress and diagnosed with a myasthenic crisis. Therapeutic Plasma Exchange (TPE) with albumin was initiated to manage her crisis, but following the first TPE session, she developed a type-I hypersensitivity reaction, presenting as widespread urticaria. Despite antihistamine treatment, she experienced oxygen desaturation. Laboratory tests revealed elevated CRP, hypoalbuminemia, and electrolyte imbalances, likely exacerbated by pneumonia as a precipitating factor. TPE sessions continued under close monitoring, and her symptoms gradually stabilized.
Conclusion: This case highlights the importance of recognizing type-I hypersensitivity as a potential complication of TPE in MG patients. While TPE is effective in controlling myasthenic crises, prompt management of hypersensitivity reactions is crucial to prevent severe outcomes.
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