[A comparative study of intravenous immunoglobulin and plasmapheresis preoperatively in myasthenia].
BACKGROUND
Thymectomy is a well established procedure in myasthenia gravis (MG). To reduce its morbidity, treatments which are effective in the short term, such as plasmapheresis and intravenous immunoglobulin (IGI) have been used.


OBJECTIVE
To evaluate the efficacy and tolerability of the IGI, compared with plasmapheresis, in the preparation of myasthenic patients before thymectomy.


METHODS
We compared a group of 33 prospective myasthenic patients treated with IGI with 38 clinical histories taken as controls treated by plasmapheresis during the peri operative period of thymectomy.


RESULTS
The patients treated with IGI were in the intensive care unit and neurology ward for less time. The endotracheal tube was also removed sooner. However, these differences were not significant. The commonest complications of IGI were fever, shivering and phlebitis. The most frequent adverse reaction to plasmapheresis were cutaneous eruptions. One patient developed Hepatitis C after plasmapheresis.


CONCLUSIONS
IGI is comparable in efficacy to plasmapheresis in the peri operative period of MG, but has a better profile of adverse reactions.
Pérez Nellar
J
J
Servicio de Neurología, Hospital Clínico Quirúrgico Hermanos Ameijeiras, La Habana, 10300, Cuba. jpnellar@yahoo.com
Domínguez
A M
AM
Llorens-Figueroa
J A
JA
Ferrá-Betancourt
A
A
Pardo
A
A
Quiala
M
M
Gali
Z
Z
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000601:surgery*; D010956:Plasmapheresis / Q000379:methods*; D011182:Postoperative Care; D011241:Prednisone / Q000627:therapeutic use*; D011300:Preoperative Care; D013934:Thymectomy / Q000379:methods*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D011241:Prednisone