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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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open access

Published: 24 October 2022

Characteristics of Therapeutic Plasma Exchange Procedures in Patients with Myasthenia Gravis and Guillain Barre Syndrome and their Outcomes during Hospitalization in General Intensive Care Unit Hasan Sadikin General Hospital Bandung in January 2017 to December 2020

Tinni T. Maskoen, Aditiya Amini Inggriani, M. Erias Erlangga

Padjadjaran University

journal of social and political sciences
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Pages: 45-54

Keywords: Guillain Barre Syndrome, Length of Stay, Myasthenia Gravis, Morbidity, Mortality, Therapeutic Plasma Exchange


Background: Myasthenia Gravis and Guillain-Barré syndrome are two of the most common autoimmune diseases affecting the peripheral nervous system in the world. Both of the diseases manifested as progressive muscle weakness, areflexia, and inspiratory muscle weakness which leads to mechanical ventilation support. Therapeutic Plasma Exchange is the first line of treatment according to the American Society for Apheresis (AFSA), which is a relatively safe and often performed procedure In the Intensive Care Unit (ICU), including in Hasan Sadikin Hospital Bandung (RSHS). Purpose: The goal of this study is to obtain the background characteristics of MG and GBS patients and to obtain the outcome of TPE in these patients. Methods: The study was a descriptive study performed on 30 MG and GBS patients who received TPE in the Intensive care unit, RSHS from January 2017 to December 2020. Data for the study was obtained retrospectively from the patient medical record. Results: The result showed that the most common side effect during TPE was electrolyte imbalance. There was no reported morbidity and mortality in MG patients, in contrast to two mortality cases in GBS patients. Length of stay in the intensive care unit was influenced by several factors including age, comorbidities, the severity of MG, and morbidities that occurred during the hospital stay. Conclusion: Outcome of MG and GBS patients with TPE procedure is good in relation with low TPE-unrelated morbidity and mortality.


  1. Aydin, Y., Ulas, A. B., Mutlu, V., Colak, A., & Eroglu, A. (2017). Thymectomy in myasthenia gravis. The Eurasian Journal of Medicine, 49(1), 48-52.

  2. Murthy, J. M. K. (2020). Myasthenia gravis: do the subtypes matter? Ann Indian Acad Neurol, 23(1), 2.

  3. Biswas, A., Singh, H., Philip, J., Pawar, A., & Joshi, R. (2020). A retrospective study on patients of guillain-barre syndrome treated with therapeutic plasma exchange at a tertiary care hospital in western Maharashtra. Global Journal of Transfusion Medicine. 5(2), 173-177.

  4. Ortiz-Salas, P., Velez-Van-Meerbeke, A., Galvis-Gomez, C. A., & Rodriguez, Q. (2016). Human immunoglobulin versus plasmapheresis in guillain-barre syndrome and myasthenia gravis: a meta-analysis. Journal of Clinical Neuromuscular Disease. 18(1), 1-11.

  5. Westerberg, E. & Punga, A. R. (2020). Epidemiology of myasthenia gravis in sweden 2006-2016. Brain and Behavior. 10(11), e01819.

  6. Nguyen, T. C., Kiss, J. E., Goldman, J., & Carcillo, J. A. (2012). The role of plasmapheresis in critical illness. Crit Care Clin, 28(3). 453-468.

  7. McCullough, P. (2019). Contrast induced acute kidney injury. Critical Care Nephrology.

  8. Li, L., Xiong, W. C., & Mei, L. Neuromuscular junction formation, aging, and disorders. Annual Review of Physiology. 2018. 80(1), 159-188.

  9. Pham, H. P., Staley, E. M., & Schwartz, J. (2019). Therapeutic plasma exchange – a brief review of indications, urgency, schedule, and technical aspects. Transfusion and Apheresis Science. 58(3), 237-246.

  10. Daga Ruiz, D., Fonseca San Miguel, F., González de Molina, F. J., Úbeda-Iglesias, A., Navas Perez, A., & Jannone Fores, R. (2017). Plasmapheresis and other extracorporeal filtration techniques in critical patients. Medicina Intensiva, 41(3), 174-187.

  11. Calca, R., Gaspar, A., Santos, A., Aufico, A., Freitas, P., & Coelho, S. (2020). Therapeutic plasma exchange in patients in a portuguese ICU. Portuguese Journal of Nephrology & Hypertension, 34(1): 21-25.

  12. Bubuioc, A. M., Kudebayeva, A., Turuspekova, S., Lisnic, V., & Leone, M. A. (2021). The epidemiology of myasthenia gravis. Journal of Medicine and Life, 14(1), 7-16.

  13. Sejva r, J. J., Baughman, A. L., Wise, M., & Morgan, O. W. (2011). Population incidence of guillain-barré syndrome: a systematic review and meta-analysis. Neuroepidemiology, 36(2), 123-133.

  14. Dong, D., Chong, M., Wu, Y., Kaminski, H., Cutter, G., & Xu, X. (2020). Gender differences in quality of life among patients with myasthenia gravis in china. Health Qual Life Outcomes, 18(1), 1–13.

  15. Liu, X. D., Shao, M. R., Sun, L., Zhang, L., Jia, X. S., & Li, W. Y. (2017). Influence of body mass index on postoperative complications after thymectomy in myasthenia gravis patients. Oncotarget, 8(55), 94944–94950.

  16. Winer, J. B. (2014). An update in guillain-barré syndrome. Autoimmune Diseases, 2014, 1-6.

  17. Ou, S. M., Liu, C. J., Chang, Y. S., Hu, Y. W., Chao, P. W., & Chen, T. J. (2013). Tuberculosis in myasthenia gravis. The International Journal of Tuberculosis and Lung Disease, 17(1), 79-84.

  18. Hakim, M., Gunadharma, S., & Basuki, M. (2019). Pedoman Tatalaksana GBS, CIDP, MG, Imunoterapi [Instructions for the conduct of GBS, CIDP, MG, immunotherapy]. Perhimpunan Dokter Spesialis Saraf Indonesia, 75-76.

  19. Babariya, S. P., Vivero, A., Peedin, A., & Karp, J. K. (2021). Therapeutic plasma exchange in patients with severe obesity: A survey of practices in the United States. Journal of Clinical Apheresis, 36(6), 802-807.

  20. Sergent, S. R. & Ashurst, J. V. (2022) Plasmapheresis. Treasure Island (FL): StatPearls Publishing.

  21. Neumann, B., Angstwurm, K., Mergenthaler, P., Kohler, S., Schonenberger, S., & Bosel, J. (2020). Myasthenic crisis demanding mechanical ventilation. Neruology, 94(3), e299-313.

  22. Siddiqui, S. H., Siddiqui, T., H., Babar M., Khoja A., & Khan, S. (2019). Outcomes of patients with guillain barre syndrome – experience from a tertiary care hospital of a developing Asian country and review of regional literature. Journal of Clinical Neuroscience, 36(6), 802-807.

  23. Lal, V., Prabhakar, S., Agarwal, R., & Sharma, S. (2013). Clinical profile and outcome of myasthenic crisis in a tertiary care hospital: a prospective study. Ann Indian Acad Neurol, 16(2), 203.

  24. Portugal Rodríguez, E., Berrazueta Sánchez de Vega, A., Vara Arlanzón, R., Martínez Barrio, E., del Valle Ortiz, M., & Fernández Ratero, J. (2015). Predisposing factors, neurological complications and sequels of Guillain Barre Syndrome at discharge: experience in an ICU of a third level hospital. Intensive Care Medicine Experimental, 3(Suppl 1), A993.

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