{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:56:06Z","timestamp":1779897366967,"version":"3.53.1"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aim<\/jats:title><jats:p>Antibody overshoot following therapeutic plasmapheresis (PLEX) is defined by subsequent increase in antibody to levels exceeding those prior to removal. It has been infrequently described in the past, and its influence on the clinical course of myasthenia gravis (MG) remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of five patients with generalized MG treated with PLEX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All five patients possessed antibodies against acetylcholine receptor (AChR\u2010Ab). After undergoing 3 to 12 PLEX treatment sessions, AChR\u2010Ab titer increased to a median of 1292% of the baseline level. The median interval from the last PLEX session to peak AChR\u2010Ab detection was 6\u00a0wk. In four patients, AChR\u2010Ab overshoot was associated with a clinical deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The AChR\u2010Ab overshoot may occur following PLEX. In patients who deteriorate following PLEX treatment, the presence of antibody overshoot may serve as additional guidance for treatment adjustment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27341","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T11:34:51Z","timestamp":1622633691000},"page":"483-487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Myasthenia gravis exacerbation in association with antibody overshoot following plasmapheresis"],"prefix":"10.1002","volume":"64","author":[{"given":"Jason","family":"Ching","sequence":"first","affiliation":[{"name":"Department of Neurology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-4575","authenticated-orcid":false,"given":"Richard A.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Neurology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4248-8927","authenticated-orcid":false,"given":"Yuebing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,25]]},"reference":[{"issue":"4","key":"e_1_2_10_2_1","article-title":"Plasma exchange for myasthenia gravis","author":"Gajdos P","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916934.2016.1214823"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2007.05.033"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"35","article-title":"Rebound and overshoot after plasma exchange in humans","volume":"104","author":"Derksen RH","year":"1984","journal-title":"J Lab Clin Med"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920050304"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)01595-2"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12923"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/201754"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5728(95)00121-4"},{"key":"e_1_2_10_11_1","first-page":"229","volume-title":"Plasmapheresis and the Immunobiology of Myasthenia Gravis","author":"Dau PC","year":"1979"},{"key":"e_1_2_10_12_1","first-page":"124","volume-title":"Plasmapheresis and the Immunobiology of Myasthenia Gravis","author":"Keesey J","year":"1979"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285611411503"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23944"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-198805000-00005"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.10.043"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920100410"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27341","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.27341","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27341","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T14:43:43Z","timestamp":1692974623000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,25]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1002\/mus.27341"],"URL":"https:\/\/doi.org\/10.1002\/mus.27341","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,25]]},"assertion":[{"value":"2020-11-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}