Abstract
Formation of antibodies (AB) to receptors in myasthenia gravis (MG) significantly reduces gas exchange, due to disruption of respiration and due to the fact that plasmaphresis (PPH), which removes AB from blood, negatively influences on erythrocytes (E) and causes formation of microthrobi (MT) in pulmonary (P) cappilaries (C). The co-existence of 2 factors causes hypoxia and urges to look for the ways of correction.
Objectives: To study lungs (L) and E in M and influence of ILIB on E forms in PPH.
Methods. L samples obtained during thymectomy, and E of peripheral blood (PB) were studied with light, scanning and transmission electron microscopies. “thick film”express-method, elaborated in laboratory, was used to assess E. ILIB was carried out with “Matrix-VLOK”.
Results. The changes in L in M manifested by reduction of osmiophilic dense bodies in pneumocytes; irregular shaped E, sludged in C, and MT. The number of PFE in M was: echinocytes (EC)-17%, stomatocytes (SC)-16%; dyscocytes (DC)-62%, compared to 89% normal.
PPH, eliminating AB and improving patients’ status, caused, at the same time, increase of PFE; SC-20%, EC to 25%, share of DC reduced to 50-55%. Use of ILIB in combination with PPH restored DC to 58-60%, while correspondingly decreased PFE: EC– 15-18%, SC-18%.
Conclusion M causes structural and functional changes in L. PPH, along with elimination of AB increases PFE, share of which in M is higher than in norm. Integrated use of laser therapy and PPH provides elimination of AB on the one hand, and restores normal E on the other. This allows recommending ILIB as an effective way to impact on E in complex treatment of myasthenia gravis.
- © 2013 ERS
