Intended for healthcare professionals

Research Article

Successful treatment of exophthalmos and pretibial myxoedema with plasmapheresis.

Br Med J 1979; 1 doi: (Published 10 February 1979) Cite this as: Br Med J 1979;1:374
  1. P Dandona,
  2. N J Marshall,
  3. S P Bidey,
  4. A Nathan,
  5. C W Havard


    A patient with Graves's disease with acute progressive exophthalmos and pretibial myxoedema was treated twice with plasmapheresis. Two weeks after the first treatment the symptoms recurred, but 20 weeks after the second treatment the exophthalmos was much improved and the pretibial myxoedema had disappeared. Analysis of sequential serum IgG concentrations and the thyroid-stimulating immunoglobulin index suggested that the two conditions were caused by specific IgGs. The results suggest that plasmapheresis has a useful place in the treatment of acute and rapidly progressive ophthalmopathy and pretibial myxoedema in patients with Graves's disease.