Figure 3: Clinical course and therapeutic process (after DFPP) (DFPP: Double-filtration plasmapheresis; OCMC: Ohmihachiman Community Medical Center; KPUM: Kyoto Prefectural University of Medicine). This figure summarizes the approximately 16 months from first introduction of DFPP until the patient’s death. At first, a series of DFPP administrations brought improvements of MG symptoms. However, the duration of the effect was gradually shortened. About 6 months after first introduction of DFPP (in October, X), routine DFPP (once every week, without admission) was started, though it eventually became ineffective. On admission to KPUM, stepwise increases in PSL allowed for prolongation of the interval between DFPP administrations.