Therapeutic Plasma Exchange (TPE) in pregnancy: A case report

Abstract

Background: Therapeutic Plasma Exchange (TPE) is a therapeutic procedure that uses an apheresis machine to remove the patient's plasma. The main goal of TPE is to eliminate pathological mediators in plasma, such as autoantibodies, immune complexes, cryoglobulins, toxins and lipids that can cause several clinical effects in patients ranging from mild symptoms such as weakness shortness of breath to paralysis and respiratory failure. This case study aims to evaluate the effect of TPE in pregnancy with a history of Myasthenia Gravis (MG). Case Presentation: A female patient, 26 years old, 16 weeks of pregnancy, with a history of MG for 3 years and regularly consumes Mestinon. The patient’s general condition is weak, with blood pressure of 100/65 mmHg, pulse rate of 110 times/minute, body temperature of 36.5oC, and breathing with the help of a ventilator. Diagnosis of 16 weeks G2P1001 with myasthenic crisis. The clinical condition improved after undergoing TPE procedures 3 times, and the patient could breathe spontaneously. Conclusion: TPE in Myasthenia gravis crisis is highly recommended and is often used as the first choice of therapy. Various physiological changes may occur during pregnancy and may affect the effectiveness and increase the side effects of TPE. Therefore, it is necessary to do some special preparation and treatment.