Treatment of myasthenia gravis with high-dose intravenous immunoglobulin.
We treated 37 patients affected by autoimmune generalized myasthenia gravis (MG) with high-dose intravenous gammaglobulin (HDIVIg), 400 mg/kg per day on 5 consecutive days. A one-degree improvement of Oosterhuis global clinical classification of myasthenic severity (OGCCMS), the disappearance of bulbar involvement or both were recorded 12 days after the beginning of the treatment in 70.3% of the patients and persisted up to 60 days in 58.7%. A two-degree improvement of OGCCMS was recorded in 54.1% of the patients and it was maintained up to 60 days in 37.8%. The percentage of improvement did not significantly differ between patients entering the treatment in a long-standing, drug-refractory stationary phase of the illness (n = 26) and patients who received HDIVIg in an acute phase of MG (n = 11). None of the patients experienced side effects. Our data indicates that HDIVIg is an interesting, virtually riskless therapeutic choice for MG patients, and allows the planning of a controlled trial versus plasma-exchange.
Cosi
V
V
C. Mondino Foundation, Second Neurological Clinic, University of Pavia, Italy.
Lombardi
M
M
Piccolo
G
G
Erbetta
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis; D002648:Child; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000276:immunology / Q000628:therapy*; D009460:Neurologic Examination; D011950:Receptors, Cholinergic / Q000276:immunology; D013934:Thymectomy
D001323:Autoantibodies; D002800:Cholinesterase Inhibitors; D016756:Immunoglobulins, Intravenous; D011950:Receptors, Cholinergic